NPI | 1376575324 |
---|---|
Doing Business As | SEAPORT DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | JOHN ROBERT WEST President 860-572-9994 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
Enumeration Date | 2006-07-07 |
Last Update Date | 2013-02-06 |