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General NPI Number Information
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NPI Number | 1053598474
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Entity Type | Organization
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Legal Business Name | ALLPHASES DERMATOLOGY LLC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 6355 WALKER LN STE 311
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3258
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Country | US
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Telephone | 703-822-0222
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Fax | 703-822-8222
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Provider Business Mailing Address
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Address Line | 6355 WALKER LN STE 311
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3258
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Country | US
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Telephone | 703-822-0222
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Fax | 703-822-8222
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. YVETTE APPIAH
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Credential |
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Telephone | 703-822-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101231652
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License Number State | VA
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