DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GREAT LAKES DERMATOLOGY

Active Organization

Procedural Dermatology · PLEASANT PRAIRIE, WI

Registration Details

NPI Number
1205041688
Provider Type
Organization
NPI Issued
May 11, 2007 (18.947539435734 yrs)
Last Updated
Aug 22, 2020

Practice Information

Address
9555 76TH ST
SUITE 2600
PLEASANT PRAIRIE, WI, 531581984
Browse WI providers · Browse ZIP 53158
Phone
8004858640
Primary Specialty
Procedural Dermatology
207NS0135X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.