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MARY E TISSERAND MD PC NPI 1225495435


NPI Information

NPI: 1225495435
Provider Name: MARY E TISSERAND MD PC
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
3700 BELLEMEADE AVE
STE 200
EVANSVILLE, IN
ZIP 47714
Phone: (812) 476-1379
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MARY E TISSERAND MD PC is a procedural dermatology dermatology in Evansville, IN. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). MARY E TISSERAND MD PC NPI is 1225495435. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3700 BELLEMEADE AVE
STE 200
EVANSVILLE, IN
ZIP 47714-125
Phone: (812) 476-1379

The provider's authorized official is Mary E Tisserand .
The authorized official title is Owner and has the following contact phone number (812) 476-1379.

The enumeration date for this NPI number is 1/19/2016 and was last updated on 1/19/2016.


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
1207NS0135XDermatologyProcedural Dermatology01037184INDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E03773MEDICARE UPININDIANA

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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