NPI | 1558944504 |
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Doing Business As | THE DERM, A FOREFRONT DERMATOLOGY PRACTICE |
Entity Type | Organization |
Authorized Contact | DENISE L ANGER Sr. Director, Provider Enrollment 920-663-9022 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
207NS0135X Dermatology, Procedural Dermatology | |
2085R0202X Radiology, Diagnostic Radiology | |
Enumeration Date | 2021-04-28 |
Last Update Date | 2023-05-11 |