| NPI | 1629103114 |
|---|---|
| Doing Business As | DERMTOLOGY CENTER OF WILLIAMSBURG |
| Entity Type | Organization |
| Authorized Contact | MICHELE RAE SELBY Practice Administrator 757-645-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 3098297754) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2008-02-12 |