Avalon Dermatology LLC

NPI #1366208456 in Warren, Ohio

Provider Information

NPI Number: 1366208456
Entity Type: Organization
Organization Name: Avalon Dermatology LLC
Primary Specialty: Dermatology
Enumeration Date: Feb 26, 2024
Last Updated: Apr 17, 2024

Practice Location

Address: 1 AMERICAN WAY NE
City: Warren
State: Ohio
ZIP Code: 44484-5531
Phone: (330) 609-8814

Authorized Official

Name: ROBERT T MOOSALLY, DO
Title: MEDICAL DIRECTOR
Phone: (330) 609-8814

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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