Clinical Dermatology Center, LLC

NPI #1902428709 in Chantilly, Virginia

Provider Information

NPI Number: 1902428709
Entity Type: Organization
Organization Name: Clinical Dermatology Center, LLC
Primary Specialty: Dermatology
Enumeration Date: May 14, 2020
Last Updated: Jul 17, 2020

Practice Location

Address: 14500 AVION PKWY STE 100
City: Chantilly
State: Virginia
ZIP Code: 20151-1108
Phone: (703) 705-7000

Authorized Official

Name: MR. MIKHAIL A PAVLOV
Title: PRACTICE MANAGER
Phone: (410) 371-6302

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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