Great Lakes Dermatology in Racine - Procedural Dermatology
Great Lakes Dermatology - NPI 1689757569
Great Lakes Dermatology is a Procedural Dermatology in Racine, Wisconsin. Great Lakes Dermatology practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Great Lakes Dermatology is 1689757569. The last update date is 2020-08-22.
Great Lakes Dermatology's current location address is 1515 S Greenbay Rd, Racine, Wisconsin. You can contact this provider via phone number 2626322074 and fax number 2626322656. The mailing address for Great Lakes Dermatology is 1515 S Greenbay Rd, Racine, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Great Lakes Dermatology |
|---|---|
| Address | 1515 S Greenbay Rd, Racine, Wisconsin |
| Phone Number | 2626322074 |
| Fax Number | 2626322656 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Dean J Cathy |
| Telephone Number | 8004858640 |
NPI Number Detail
| NPI Number | 1689757569 |
|---|---|
| Provider Enumeration Date | 2006-10-23 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1515 S Greenbay Rd |
|---|---|
| City | Racine |
| State | Wisconsin (WI) |
| Post Code | 534064409 |
| Phone Number | 2626322074 |
| Fax Number | 2626322656 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
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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 10-digit identification 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) 1689757569 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Great Lakes Dermatology located?
The Great Lakes Dermatology is located at 1515 S Greenbay Rd, Racine, WI 534064409.
What is the Great Lakes Dermatology's area of specialization and corresponding taxonomy classification?
The Great Lakes Dermatology's specialty field is Procedural Dermatology, and it falls under the taxonomy code 207Ns0135X, which categorizes healthcare providers based on their specialties.
When did the Great Lakes Dermatology receive its 1689757569?
The Great Lakes Dermatology was issued its 1689757569 on 2006-10-23, which is the date when the organization was assigned this unique identifier.
When was the information pertaining to Great Lakes Dermatology most recently updated or revised?
The details related to Great Lakes Dermatology, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.