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Advanced Dermatology Of Maryland PC

Dermatology in Rockville, MD. Organization (NPI-2).

NPI number1760856413
StatusActive
Last updated in NPPESJan 22, 2018

Details

NPI
1760856413
Entity type
Organization (NPI-2)
Legal business name
Advanced Dermatology Of Maryland PC
Organization subpart
No
Enumeration date
Nov 18, 2015
Last updated
Jan 22, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology––Yes

Practice location

2401 Research Blvd Ste 260
Rockville, MD 20850-3261

Phone 301-990-6565 · Fax 301-990-8525

Mailing address

151 Southhall Ln
Suite 300
Maitland, FL 32751-7176

Phone 407-875-2080 · Fax 407-650-3455

Authorized official

Matt Louis Leavitt
DO / Owner
4078752080

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