| NPI | 1083332951 |
|---|---|
| Doing Business As | UNIVERSITY DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | CAROL BURGESS Provider Enrollment Team Lead 865-670-6754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-09-28 |