| NPI | 1083200794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RUTH PETERMAN Md 443-351-3376 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207NS0135X Dermatology, Procedural Dermatology | |
| 207ZD0900X Pathology, Dermatopathology | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-04-23 |