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NEW DERMATOLOGY GROUP LTD NPI 1356784334


NPI Information

NPI: 1356784334
Provider Name: NEW DERMATOLOGY GROUP LTD
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 52D2106871

Address:
1747 SHAWANO AVE
GREEN BAY, WI
ZIP 54303
Phone: (920) 965-0345
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NEW DERMATOLOGY GROUP LTD is a dermatology in Green Bay, WI. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. NEW DERMATOLOGY GROUP LTD NPI is 1356784334. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1747 SHAWANO AVE
GREEN BAY, WI
ZIP 54303-243
Phone: (920) 965-0345

The provider's authorized official is Kevan Lewis .
The authorized official title is Owner and has the following contact phone number (920) 965-0345.

The CLIA number assigned to this NPI record is 52D2106871 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/9/2013 and was last updated on 4/9/2013.


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
1207ND0101XDermatologyMOHS-Micrographic Surgery53110-20WISCONSINNo
2207ND0900XDermatologyDermatopathology53110-20WISCONSINNo
3207NI0002XDermatologyClinical & Laboratory Dermatological Immunology53110-20WISCONSINNo
4207NS0135XDermatologyProcedural Dermatology53110-20WISCONSINNo
5207N00000XDermatology53110-20WISCONSINYes

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: 11/14/2023

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