Provider Type Icon

PHOENIX SURGICAL DERMATOLOGY GROUP LLC NPI 1447884929


NPI Information

NPI: 1447884929
Provider Name: PHOENIX SURGICAL DERMATOLOGY GROUP LLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 03D2181402

Address:
4550 E BELL RD BLDG 5
PHOENIX, AZ
ZIP 85032
Phone: (480) 666-5568
Get Directions

PHOENIX SURGICAL DERMATOLOGY GROUP LLC is a mohs-micrographic surgery dermatology in Phoenix, AZ. 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. PHOENIX SURGICAL DERMATOLOGY GROUP LLC NPI is 1447884929. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4550 E BELL RD BLDG 5
PHOENIX, AZ
ZIP 85032-390
Phone: (480) 666-5568
Fax: (702) 297-6238

The provider's authorized official is Ramin Fathi .
The authorized official title is Owner and has the following contact phone number (480) 666-5568.

The CLIA number assigned to this NPI record is 03D2181402 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/24/2020 and was last updated on 2/29/2020.


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
1207N00000XDermatologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryYes
3207ND0900XDermatologyDermatopathologyNo
4207NS0135XDermatologyProcedural DermatologyNo

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.