Healthcare Provider Details

I. General information

NPI: 1396852133
Provider Name (Legal Business Name): ASSOCIATES IN DERMATOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 CROCKER RD STE 109
WESTLAKE OH
44145-6710
US

IV. Provider business mailing address

2205 CROCKER RD STE 109
WESTLAKE OH
44145-6710
US

V. Phone/Fax

Practice location:
  • Phone: 440-482-8323
  • Fax: 440-808-1718
Mailing address:
  • Phone: 440-482-8323
  • Fax: 440-808-1718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDIE STYRON
Title or Position: PHYSICIAN/PARTNER
Credential: M.D.
Phone: 440-482-8323