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FREDERICK WALTER GOURDIN MD NPI 1215902663


NPI Information

NPI: 1215902663
Provider Name: FREDERICK WALTER GOURDIN, MD
Classification: Dermatology - 207ND0101X
Entity Type: Individual

Specialization: MOHS-Micrographic Surgery

Address:
78 LONG SHOALS RD
ARDEN, NC
ZIP 28704
Phone: (828) 684-0703
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Frederick Walter Gourdin, MD is a mohs-micrographic surgery dermatology in Arden, NC. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Frederick Walter Gourdin, MD NPI is 1215902663. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

78 LONG SHOALS RD
ARDEN, NC
ZIP 28704-782
Phone: (828) 684-0703
Fax: (828) 684-5344

The enumeration date for this NPI number is 2/21/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic Surgery9800549NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12255486MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINAMEDICARE PROVIDER NUMBER
28911375MEDICAIDNORTH CAROLINA
3B04230MEDICARE UPINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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