Paladin Dermatology Llc

NPI 1225417082 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1225417082
Enumeration Date 05/27/2015
Last Updated 10/27/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JOE JOE
Position MANAGING OFFICIAL
Phone (804) 648-4802
Fax
Practice Location
44 A& B MEDICAL PARK BLVD
PETERSBURG VA, 23805, US
Phone (804) 648-4802
Fax
Business Location
1801 LIBBIE AVE STE 204
RICHMOND VA, 23226-1836, US
Phone
Fax
Toxanomy
Taxonomy Code 363L00000X
License State Virginia
License Number 0024164803
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According to our database, Paladin Dermatology Llc NPI is 1225417082, taxonomy code is 363L00000X and license number is 0024164803, license state is located at Virginia. Paladin Dermatology Llc physically located at 44 A& B Medical Park Blvd, Petersburg VA, 23805. NPI Number 1033115704 has the healthcare provider type.

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1225417082 NPI number is provided on an as is basis without warranty of any kind. 1225417082 is maintained by the National Plan & Provider Enumeration System. The contents of Paladin Dermatology Llc are for informational purposes only.