NPI 1477388197 · live from the CMS NPI Registry
Advanced Dermatology Of Maryland PC
Dermatology in La Plata, MD. National Provider Identifier 1477388197, active.
NPI record
| NPI | 1477388197 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 101 Centennial St Ste H, La Plata, MD 20646 |
| Practice phone | 301-292-6010 |
| Mailing address | 151 Southhall Ln Ste 300, Maitland, FL 32751 |
| Enumerated | September 3, 2024 |
| Last updated | September 3, 2024 |
| Authorized official | Matt Leavitt, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.