Healthcare Provider Details

I. General information

NPI: 1811402423
Provider Name (Legal Business Name): DERMIO DERMATOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 CALUMET AVE STE 203
MUNSTER IN
46321-2885
US

IV. Provider business mailing address

9200 CALUMET AVE STE 203
MUNSTER IN
46321-2885
US

V. Phone/Fax

Practice location:
  • Phone: 219-228-4200
  • Fax: 844-965-9457
Mailing address:
  • Phone: 415-802-1310
  • Fax: 844-965-9457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARMAN SOLEYMANI
Title or Position: OWNER
Credential: MD
Phone: 415-802-1310