Healthcare Provider Details

I. General information

NPI: 1215076112
Provider Name (Legal Business Name): FAMILY DERMATOLOGY OF ALBEMARLE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WAYLES LN SUITE 150
CHARLOTTESVILLE VA
22911-4631
US

IV. Provider business mailing address

215 WAYLES LN SUITE 150
CHARLOTTESVILLE VA
22911-4631
US

V. Phone/Fax

Practice location:
  • Phone: 434-964-9500
  • Fax: 434-964-9501
Mailing address:
  • Phone: 434-964-9500
  • Fax: 434-964-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101237413
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License Number0101237413
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number0101237413
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number0101237413
License Number StateVA

VIII. Authorized Official

Name: DR. BRETT DOUGLAS KRASNER
Title or Position: OWNER
Credential: M.D.
Phone: 434-964-9500