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CENTER FOR DERMATOLOGY AND DERMATOLOGIC SURGERY MANAGEMENT LLC NPI 1508103011


NPI Information

NPI: 1508103011
Provider Name: CENTER FOR DERMATOLOGY AND DERMATOLOGIC SURGERY MANAGEMENT, LLC

Former Legal Business Name: CENTER FOR DERMATOLOGY

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 09D2009565

Address:
167 JENNIFER RD STE W
ANNAPOLIS, MD
ZIP 21401
Phone: (410) 224-1195
Get Directions

CENTER FOR DERMATOLOGY AND DERMATOLOGIC SURGERY MANAGEMENT, LLC is a procedural dermatology dermatology in Annapolis, MD. 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). CENTER FOR DERMATOLOGY AND DERMATOLOGIC SURGERY MANAGEMENT, LLC NPI is 1508103011. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Center For Dermatology.

The provider's business location address is:

167 JENNIFER RD STE W
ANNAPOLIS, MD
ZIP 21401-910
Phone: (410) 224-1195

The provider's authorized official is Cheryl M Burgess .
The authorized official title is Medical Director and has the following contact phone number (202) 955-5757.

The CLIA number assigned to this NPI record is 09D2009565 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/4/2013 and was last updated on 1/4/2013.


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 DermatologyYes

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
1E13427MEDICARE UPIN

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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