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Physicians Dermatology MOHS-Micrographic Surgery

Provider NPI: 1861684748

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 605-342-3280  Fax: 605-721-8458

Business Mailing Address:
PO BOX 6020  RAPID CITY, SD 57709-6020 US
Tel: 605-342-3280  Fax: 605-721-8458

NPI Information:
NPI: 1861684748
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
MOHS-Micrographic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207N00000X





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