Provider Demographics
NPI:1285699066
Name:WERNIKOFF, STUART YALE (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:YALE
Last Name:WERNIKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 RANDOLPH RD
Mailing Address - Street 2:STE. 210
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1200
Mailing Address - Country:US
Mailing Address - Phone:704-333-8811
Mailing Address - Fax:704-333-9504
Practice Address - Street 1:2015 RANDOLPH RD
Practice Address - Street 2:STE. 210
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1200
Practice Address - Country:US
Practice Address - Phone:704-333-8811
Practice Address - Fax:704-333-9504
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28712207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology