Integrated Dermatology Of Reston, LLC
Dermatology in Reston, VA. Organization (NPI-2).
NPI number1487186466
StatusActive
Last updated in NPPESJan 28, 2019
Details
- NPI
- 1487186466
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Dermatology Of Reston, LLC
- Organization subpart
- No
- Enumeration date
- Mar 30, 2017
- Last updated
- Jan 28, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
1886 Metro Center Dr Ste 650Reston, VA 20190-5294
Phone 703-437-7744
Mailing address
4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450
Phone 561-314-2000 · Fax 561-431-2821
Authorized official
Adam S. Plotkin
Authorized Official
5613142000
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