Integrated Dermatology of Gloucester, LLC

NPI #1710479936 in Gloucester, Virginia

Provider Information

NPI Number: 1710479936
Entity Type: Organization
Organization Name: Integrated Dermatology of Gloucester, LLC
Primary Specialty: Dermatology
Enumeration Date: Jun 4, 2018
Last Updated: Jun 4, 2018

Practice Location

Address: 6790 WOOD RIDGE DR
City: Gloucester
State: Virginia
ZIP Code: 23061-4377
Phone: (804) 693-6527

Authorized Official

Name: JEFFREY D. QUEEN
Title: MANAGER
Phone: (561) 314-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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