| 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 |