Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GREAT LAKES DERMATOLOGY
Active OrganizationGREAT LAKES DERMATOLOGY is a Procedural Dermatology organization located in KENOSHA, Wisconsin. NPI 1558576322 is currently active in the NPPES registry. Verify at CMS.
Procedural Dermatology · KENOSHA, WI
Registration Details
- NPI Number
- 1558576322
- Provider Type
- Organization
- NPI Issued
- May 14, 2007 (19.262494192009 yrs)
- Last Updated
- Aug 22, 2020
Practice Information
- Address
-
3601 30TH AVESUITE 210KENOSHA, WI, 531441695Browse WI providers · Browse ZIP 53144
- Phone
- 2626582594
- 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.