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 |