OrganizationActive
South Charleston Dermatology PLLC
NPI 1174604409 · Dermatology Physician · South Charleston, WV
Provider details
- NPI number
- 1174604409
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Endicott, Owner/Physician(304) 768-4567
- License
- 2097 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4815 Kanawha Ave Sw
South Charleston, WV 25309-1207
Phone: (304) 768-4567
Fax: (304) 768-2277
Street-level locationGet directions
Mailing address
4815 Kanawha Ave Sw
South Charleston, WV 25309-1207
Registry dates
- Enumerated
- 2006-10-17
- Last updated
- 2011-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.