Tidewater Dermatology, LLC

NPI #1891188991 in Berlin, Maryland

Provider Information

NPI Number: 1891188991
Entity Type: Organization
Organization Name: Tidewater Dermatology, LLC
Primary Specialty: Dermatology
Enumeration Date: Mar 13, 2015
Last Updated: Aug 21, 2015

Practice Location

Address: 314 FRANKLIN AVE
Address 2: SUITE 107
City: Berlin
State: Maryland
ZIP Code: 21811-1215
Phone: (410) 641-2222

Authorized Official

Name: DR. ANNE P SPILLANE, M.D.
Title: MANAGING PARTNER
Phone: (410) 641-2222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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