Mid Atlantic Dermatology

NPI #1073605333 in Chesapeake, Virginia

Provider Information

NPI Number: 1073605333
Entity Type: Organization
Organization Name: Mid Atlantic Dermatology
Primary Specialty: Dermatology
Enumeration Date: Sep 28, 2006
Last Updated: Jul 9, 2008

Practice Location

Address: 109 WIMBLEDON SQ
Address 2: SUITE E
City: Chesapeake
State: Virginia
ZIP Code: 23320-4945
Phone: (757) 547-9830

Authorized Official

Name: MRS. ROSE ANN WALLER
Title: BILLING MANAGER
Phone: (757) 547-9830

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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