| NPI | 1598056582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK P. EID Medical Director 540-373-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101249163) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2021-08-25 |