Healthcare Provider Details

I. General information

NPI: 1093781783
Provider Name (Legal Business Name): LANCASTER SKIN CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 N POINTE BLVD STE 1
LANCASTER PA
17601
US

IV. Provider business mailing address

190 N POINTE BLVD STE 1
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-6444
  • Fax: 717-569-1044
Mailing address:
  • Phone: 717-560-6444
  • Fax: 717-569-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. WILLIAM KARL ANDERSEN
Title or Position: PRESIDENT LANCASTER SKIN CENTER PC
Credential: MD
Phone: 717-560-6444