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COMMONWEALTH DERMATOLOGY P.C. NPI 1609239847


NPI Information

NPI: 1609239847
Provider Name: COMMONWEALTH DERMATOLOGY, P.C.
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 39D2116761

Address:
3055 WASHINGTON RD
SUITE 203
MC MURRAY, PA
ZIP 15317
Phone: (724) 260-5424
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COMMONWEALTH DERMATOLOGY, P.C. is a dermatology in Mc Murray, PA. 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. COMMONWEALTH DERMATOLOGY, P.C. NPI is 1609239847. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3055 WASHINGTON RD
SUITE 203
MC MURRAY, PA
ZIP 15317-279
Phone: (724) 260-5424
Fax: (724) 260-5425

The provider's authorized official is Matthew Shane Petrie .
The authorized official title is President and has the following contact phone number (336) 403-5331.

The CLIA number assigned to this NPI record is 39D2116761 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/4/2016 and was last updated on 6/6/2016.


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
1207ND0101XDermatologyMOHS-Micrographic SurgeryMD438908PENNSYLVANIANo
2207N00000XDermatologyMD438908PENNSYLVANIAYes

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
1498185MEDICARE PINPENNSYLVANIA
2103091870-0001MEDICAIDPENNSYLVANIA

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: 5/5/2024

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