| NPI | 1942976378 |
|---|---|
| Doing Business As | GRENADA DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | CESAR E GUERRERO CEO 662-307-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2023-09-06 |