| NPI | 1891188991 |
|---|---|
| Doing Business As | TIDEWATER DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | ANNE P SPILLANE Managing Partner 410-641-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-08-21 |