PREMIER DERMATOLOGY NPI 1104270834

NPI Information

NPI: 1104270834
Provider Name: PREMIER DERMATOLOGY
Classification: Physician Assistant - 363AM0700X
Specialization: Medical
Entity Type: Organization
Doing Business As: PANZER DERMATOLOGY
CLIA Number: 08D0682019
Address: 537 STANTON CHRISTIANA RD
SUITES 107,111,207 & 209
NEWARK, DE
ZIP 19713
Phone: (302) 633-7550

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NPI Details

PREMIER DERMATOLOGY is a medical physician assistant in Newark, DE. PREMIER DERMATOLOGY NPI is 1104270834. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Panzer Dermatology.

The provider's business location address is:

537 STANTON CHRISTIANA RD
SUITES 107,111,207 & 209
NEWARK, DE
ZIP 19713-146
Phone: (302) 633-7550

The provider's authorized official is Marypat Kwoka .
The authorized official title is Practice Administrator and has the following contact phone number (302) 633-7550.

The CLIA number assigned to this NPI record is 08D0682019 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2016 and was last updated on 4/19/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	C5-0001054	DELAWARE	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C5-0001054	OTHER	DELAWARE	DIVISION OF PROFESSIONAL REGULATION LICENSE

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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