| NPI | 1720611635 |
|---|---|
| Doing Business As | THE DERMATOLOGY CLINIC PA-MALVERN AVE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ADAM S STIBICH Owner/ Provider/ Physician 501-623-6100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2021-09-08 |