Peterson Dermatology, P.C. in Vidalia - Procedural Dermatology
Peterson Dermatology, P.C. - NPI 1932300886
Peterson Dermatology, P.C. is a Procedural Dermatology in Vidalia, Georgia. Peterson Dermatology, P.C. practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Peterson Dermatology, P.C. is 1932300886. The last update date is 2013-09-20.
Peterson Dermatology, P.C.'s current location address is 305 W 1st St, Vidalia, Georgia. You can contact this provider via phone number 9125389080 and fax number 9125389085. The mailing address for Peterson Dermatology, P.C. is 305 W 1st St, Vidalia, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Peterson Dermatology, P.C. |
|---|---|
| Address | 305 W 1st St, Vidalia, Georgia |
| Phone Number | 9125389080 |
| Fax Number | 9125389085 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DERMATOLOG |
|---|---|
| Authorized Official Name | Peterson Revell Letty |
| Credentials | M.D. |
| Telephone Number | 9125389080 |
NPI Number Detail
| NPI Number | 1932300886 |
|---|---|
| Provider Enumeration Date | 2007-05-29 |
| Last Updated Date | 2013-09-20 |
Provider Mailing Address Detail
| Address | 305 W 1st St |
|---|---|
| City | Vidalia |
| State | Georgia (GA) |
| Post Code | 304743302 |
| Phone Number | 9125389080 |
| Fax Number | 9125389085 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | 58913 |
|
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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 551383524A | GA | -- |
Post Comment/ Review Below
What is the Peterson Dermatology, P.C.'s 1932300886?
The Peterson Dermatology, P.C.'s NPI (National Provider Identifier) Number is 1932300886. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Peterson Dermatology, P.C. is geographically located?
The Peterson Dermatology, P.C. is physically situated at the following location: 305 W 1St St, Vidalia, GA, 304743302.
What is the Peterson Dermatology, P.C.'s specialty and taxonomy code?
The Peterson Dermatology, P.C.'s specialty is Procedural Dermatology, and the corresponding taxonomy code is 207Ns0135X.
On what date did the Peterson Dermatology, P.C. receive its 1932300886 assignment from the Centers for Medicare & Medicaid Services?
The Peterson Dermatology, P.C. was assigned its 1932300886 by the Centers for Medicare & Medicaid Services on 2007-05-29.
As of what date were the details related to Peterson Dermatology, P.C. most recently updated or revised?
The information pertaining to Peterson Dermatology, P.C., including its address, specialty, and other relevant details, was last updated or revised on 2013-09-20.