| NPI | 1659948594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RUTH PETERMAN President/Owner 410-766-0111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-04-22 |