| NPI | 1235403429 |
|---|---|
| Doing Business As | DERM ASSOC OF FCCC, MGI |
| Entity Type | Organization |
| Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2018-06-14 |