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General NPI Number Information
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NPI Number | 1003440355
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Entity Type | Organization
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Legal Business Name | ABSOLUTE DERMATOLOGY P.C.
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1300 WILKES RIDGE DR STE 200
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City | HENRICO
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State | VA
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Zip | 23233-7963
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Country | US
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Telephone | 804-326-4448
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Fax | 309-326-4947
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Provider Business Mailing Address
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Address Line | 1206 PORTER ST UNIT B
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City | RICHMOND
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State | VA
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Zip | 23224-2107
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Country | US
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Telephone | 757-897-5236
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Fax |
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Authorized Official
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Title or Position | MOHS SURGEON
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Name | WILLIAM SPENCER GILLEN
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Credential | MD
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Telephone | 757-897-5236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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