Visage Dermatology and Aesthetic Center, LLC

NPI #1669716395 in Largo, Maryland

Provider Information

NPI Number
1669716395
Entity Type
Organization
Organization Name
Visage Dermatology and Aesthetic Center, LLC
Primary Specialty
Dermatology
Enumeration Date
Nov 19, 2012
Last Updated
Dec 20, 2012

Practice Location

Address
1400 MERCANTILE LN
Address 2
SUITE 110
City
Largo
ZIP Code
20774-5341
Phone
(240) 223-3533

Authorized Official

Name
DR. SHARLEEN ST. SURIN-LORD, M.D.
Title
MEDICAL DIRECTOR
Phone
(240) 223-3533

Specialties & Taxonomy Codes

Specialty
Dermatology

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