DERMA GLOW MED SPA CORP NPI 1043054497

NPI Information

  • NPI: 1043054497
  • Provider Name: DERMA GLOW MED SPA CORP
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 22237 LORAIN RD
    FAIRVIEW PARK, OH
    ZIP 44126
  • Phone: (440) 641-1406

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NPI Details

DERMA GLOW MED SPA CORP is a general practice in Fairview Park, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DERMA GLOW MED SPA CORP NPI is 1043054497. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

22237 LORAIN RD
FAIRVIEW PARK, OH
ZIP 44126-315
Phone: (440) 641-1406

The provider's authorized official is Nina Kazemi Shojayi .
The authorized official title is Medical Director and has the following contact phone number (440) 641-1406.

The enumeration date for this NPI number is 6/20/2024 and was last updated on 6/30/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

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: 11/21/2025

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