NEW DERMATOLOGY GROUP LTD

GREEN BAY, WI
NPI1356784334
Entity TypeOrganization
Authorized ContactKEVAN LEWIS
Owner
920-965-0345
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: WI  53110-20)
Additional Taxonomies207ND0101X Dermatology, MOHS-Micrographic Surgery
(Licence: WI  53110-20)
207ND0900X Dermatology, Dermatopathology
(Licence: WI  53110-20)
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology
(Licence: WI  53110-20)
207NS0135X Dermatology, Procedural Dermatology
(Licence: WI  53110-20)
Enumeration Date2013-04-09
Last Update Date2013-04-09
Business Address
NEW DERMATOLOGY GROUP LTD
1747 SHAWANO AVE
GREEN BAY, WI 54303-3243
Phone number: 920-965-0345
Mailing Address
NEW DERMATOLOGY GROUP LTD
2221 S WEBSTER AVE STE 241
GREEN BAY, WI 54301-2158
Phone number: