Dermatology Center For Children & Young Adults Pa in Eagan - Pediatric Dermatology
Dermatology Center For Children & Young Adults Pa - NPI 1053417055
Dermatology Center For Children & Young Adults Pa is a Pediatric Dermatology in Eagan, Minnesota. Dermatology Center For Children & Young Adults Pa practices all healthcare services and medical treatments related to Pediatric Dermatology. The NPI Number for Dermatology Center For Children & Young Adults Pa is 1053417055. The last update date is 2008-04-20.
Dermatology Center For Children & Young Adults Pa's current location address is 2795 Pilot Knob Rd, Eagan, Minnesota. You can contact this provider via phone number 6513799999 and fax number 6513799900. The mailing address for Dermatology Center For Children & Young Adults Pa is 2795 Pilot Knob Rd, Eagan, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dermatology Center For Children & Young Adults Pa |
|---|---|
| Address | 2795 Pilot Knob Rd, Eagan, Minnesota |
| Phone Number | 6513799999 |
| Fax Number | 6513799900 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Bloom E Kenneth |
| Credentials | MD |
| Telephone Number | 6513799999 |
NPI Number Detail
| NPI Number | 1053417055 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2008-04-20 |
Provider Mailing Address Detail
| Address | 2795 Pilot Knob Rd |
|---|---|
| City | Eagan |
| State | Minnesota (MN) |
| Post Code | 551211176 |
| Phone Number | 6513799999 |
| Fax Number | 6513799900 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dermatology |
|---|---|
| Taxonomy | 207Np0225X |
|
Definition: A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2M741DE | BLUE CROSS BLUE SHIELD | ||
| 13837 | ND | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Dermatology Center For Children & Young Adults Pa by the Centers for Medicare & Medicaid Services (CMS)?
The Dermatology Center For Children & Young Adults Pa has been assigned the NPI (National Provider Identifier) 1053417055. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Dermatology Center For Children & Young Adults Pa is located?
The Dermatology Center For Children & Young Adults Pa is situated at the following address: 2795 Pilot Knob Rd, Eagan, MN, 551211176.
What is the area of specialization for Dermatology Center For Children & Young Adults Pa, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Dermatology Center For Children & Young Adults Pa is Pediatric Dermatology, and the corresponding taxonomy code that categorizes this area of expertise is 207Np0225X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1053417055 to Dermatology Center For Children & Young Adults Pa?
The Centers for Medicare & Medicaid Services originally issued the 1053417055 to Dermatology Center For Children & Young Adults Pa on 2006-09-16.
When was the information related to Dermatology Center For Children & Young Adults Pa most recently updated or refreshed?
The details pertaining to the Dermatology Center For Children & Young Adults Pa, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-04-20.
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