Northern Indiana Dermatology And Skin Surgery Center in Portage - Mohs-micrographic Surgery
Northern Indiana Dermatology And Skin Surgery Center - NPI 1639289093
Northern Indiana Dermatology And Skin Surgery Center is a Mohs-micrographic Surgery in Portage, Indiana. Northern Indiana Dermatology And Skin Surgery Center practices all healthcare services and medical treatments related to Mohs-micrographic Surgery. The NPI Number for Northern Indiana Dermatology And Skin Surgery Center is 1639289093. The last update date is 2020-08-22.
Northern Indiana Dermatology And Skin Surgery Center's current location address is 3190 Lancer St, Portage, Indiana. You can contact this provider via phone number 2197643600 and fax number 2197643661. The mailing address for Northern Indiana Dermatology And Skin Surgery Center is 3190 Lancer St, Portage, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Northern Indiana Dermatology And Skin Surgery Center |
|---|---|
| Address | 3190 Lancer St, Portage, Indiana |
| Phone Number | 2197643600 |
| Fax Number | 2197643661 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN |
|---|---|
| Authorized Official Name | Desai S Ruchik |
| Telephone Number | 2197643600 |
NPI Number Detail
| NPI Number | 1639289093 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 3190 Lancer St |
|---|---|
| City | Portage |
| State | Indiana (IN) |
| Post Code | 463684488 |
| Phone Number | 2197643600 |
| Fax Number | 2197643661 |
Provider's Primary Taxonomy Detail
| Speciality | Mohs-micrographic Surgery |
|---|---|
| Taxonomy | 207Nd0101X |
| Licence No | 207N00000X |
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Definition: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 350979 | IN | ANTHEM |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Northern Indiana Dermatology And Skin Surgery Center by the Centers for Medicare & Medicaid Services?
The Northern Indiana Dermatology And Skin Surgery Center has been assigned the NPI (National Provider Identifier) 1639289093 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Northern Indiana Dermatology And Skin Surgery Center is located?
The Northern Indiana Dermatology And Skin Surgery Center is situated at the following address: 3190 Lancer St, Portage, IN, 463684488.
What is Northern Indiana Dermatology And Skin Surgery Center's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Northern Indiana Dermatology And Skin Surgery Center is Mohs-micrographic Surgery, and the taxonomy classification code that categorizes this area of expertise is 207Nd0101X.
On what date did the Northern Indiana Dermatology And Skin Surgery Center receive its 1639289093 assignment from the Centers for Medicare & Medicaid Services?
The Northern Indiana Dermatology And Skin Surgery Center was assigned its 1639289093 by the Centers for Medicare & Medicaid Services on 2006-08-30.
As of what date was the information pertaining to Northern Indiana Dermatology And Skin Surgery Center, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Northern Indiana Dermatology And Skin Surgery Center, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.