SHADY GROVE DERMATOLOGY is a specialist in Rockville, MD. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SHADY GROVE DERMATOLOGY NPI is 1790177210. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Shady Grove Dermatology, Llc.
The provider's business location address is:
15245 SHADY GROVE RD
SUITE 370
ROCKVILLE, MD
ZIP 20850-222
Phone: (240) 246-7417
The provider's authorized official is Sandee Hall Davidson .
The authorized official title is Business Consultant and has the following contact phone number (240) 246-7417.
The CLIA number assigned to this NPI record is 21D2112261 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 2/20/2015 and was last updated on 3/5/2024.