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MIDWEST DERMATOLOGY LASER & VEIN CLINIC NPI 1174652325


NPI Information

NPI: 1174652325
Provider Name: MIDWEST DERMATOLOGY, LASER & VEIN CLINIC
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 36D1070095

Address:
3006 N CO ROAD 25-A
TROY, OH
ZIP 45373
Phone: (937) 335-2075
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MIDWEST DERMATOLOGY, LASER & VEIN CLINIC is a dermatopathology dermatology in Troy, OH. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. MIDWEST DERMATOLOGY, LASER & VEIN CLINIC NPI is 1174652325. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3006 N CO ROAD 25-A
TROY, OH
ZIP 45373-373
Phone: (937) 335-2075
Fax: (937) 339-0612

The provider's authorized official is Angie Gleason .
The authorized official title is Billing Manager and has the following contact phone number (937) 875-2745.

The CLIA number assigned to this NPI record is 36D1070095 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/5/2007 and was last updated on 4/9/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0900XDermatologyDermatopathologyYes

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: 4/28/2024

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