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NPI Code Detail

MEDICARE: ADVANCED DERMATOLOGY AND SKIN SURGERY CENTER, LLC

MEDICARE: ADVANCED DERMATOLOGY AND SKIN SURGERY CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician35059547SOH

General Provider Information

NPI Number : 1962602326
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED DERMATOLOGY AND SKIN SURGERY CENTER, LLC
Provider Business Mailing Address
First Line : 5040 FOREST DR
Second Line : STE 150
City : NEW ALBANY
State : OH
Zip : 43054-8167
Country : US
Telephone Number : 614-775-9000
Fax Number : 614-775-9002
Provider Business Practice Location Address
First Line : 5040 FOREST DR
Second Line : STE 150
City : NEW ALBANY
State : OH
Zip : 43054-8167
Country : US
Telephone Number : 614-775-9000
Fax Number : 614-775-9002
Authorized Official
Title or Position : OWNER
Name : WENDY D SCHUEN
Credential : MD
Telephone Number : 614-775-9000
Provider Enumeration Date : 07/23/2007
Last Update Date : 03/27/2013

Similar Medicare Providers

1336131127 — WENDY D SCHUEN MD
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5040 FOREST DR , STE 150
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43054-8167
Practice Phone: 614-775-9000
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1578547097 — DR. DONALD J ROHL D.O.
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1043294481 — DR. MARTIN T TAYLOR D.O.
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Practice Fax: 614-823-8881
1023071388 — JENNIFER LYNN KIBBEY PA-C
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1760407514 — MR. DAVID ALAN THOMPSON PA-C
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1083709190 — ORTHOPEDIC & NEUROLOGICAL CONSULTANTS, INC.
Practice Location Address:
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Practice Fax: 614-823-8881

Directions to “ADVANCED DERMATOLOGY AND SKIN SURGERY CENTER, LLC ” Practice Location

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