Great Lakes Dermatology in Pleasant Prairie - Procedural Dermatology
Great Lakes Dermatology - NPI 1205041688
Great Lakes Dermatology is a Procedural Dermatology in Pleasant Prairie, Wisconsin. Great Lakes Dermatology practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Great Lakes Dermatology is 1205041688. The last update date is 2020-08-22.
Great Lakes Dermatology's current location address is 9555 76th St, Pleasant Prairie, Wisconsin. You can contact this provider via phone number 8004858640. The mailing address for Great Lakes Dermatology is 9555 76th St, Pleasant Prairie, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Great Lakes Dermatology |
|---|---|
| Address | 9555 76th St, Pleasant Prairie, Wisconsin |
| Phone Number | 8004858640 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Dean Cathy |
| Telephone Number | 8004858640 |
NPI Number Detail
| NPI Number | 1205041688 |
|---|---|
| Provider Enumeration Date | 2007-05-11 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 9555 76th St |
|---|---|
| City | Pleasant Prairie |
| State | Wisconsin (WI) |
| Post Code | 531581984 |
| Phone Number | 8004858640 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
|
Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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What is the unique identifier code issued to Great Lakes Dermatology by the Centers for Medicare & Medicaid Services?
The Great Lakes Dermatology has been assigned the NPI (National Provider Identifier) 1205041688. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Great Lakes Dermatology?
The Great Lakes Dermatology is situated at 9555 76Th St, in the city of Pleasant Prairie, state of WI, with the zip code 531581984.
What is the Great Lakes Dermatology's specialty and taxonomy code?
The Great Lakes Dermatology's specialty is Procedural Dermatology, and the corresponding taxonomy code is 207Ns0135X.
On what date was the 1205041688 assigned to Great Lakes Dermatology?
The Great Lakes Dermatology was issued its 1205041688 on 2007-05-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Great Lakes Dermatology, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Great Lakes Dermatology, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
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