Healthcare Provider Details

I. General information

NPI: 1982516373
Provider Name (Legal Business Name): DERMALOGIX SKIN AND WOUND SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S CHARLES ST STE 403 # 2824
BALTIMORE MD
21201-3282
US

IV. Provider business mailing address

2504 DOMINGO CT
BRYANS ROAD MD
20616-6058
US

V. Phone/Fax

Practice location:
  • Phone: 301-893-5525
  • Fax:
Mailing address:
  • Phone: 301-893-5525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALDENE DOYLE-COLVIN
Title or Position: OWNER
Credential:
Phone: 301-893-5525