NPI 1003209248 · live from the CMS NPI Registry
Azeal Dermatology Institute, LLC
Dermatology in Boulder, CO. National Provider Identifier 1003209248, active.
NPI record
| NPI | 1003209248 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 5365 Spine Rd, Suite C, Boulder, CO 80301 |
| Practice phone | 303-530-9325 |
| Mailing address | Po Box 7446, Loveland, CO 80537 |
| Enumerated | March 12, 2015 |
| Last updated | September 15, 2015 |
| Authorized official | Stacey Pilkington, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — |
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.