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General NPI Number Information
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NPI Number | 1073151866
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Entity Type | Organization
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Legal Business Name | VIRGIN ISLANDS DERMATOLOGY, INC.
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 9150 ESTATE THOMAS STE 106
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City | ST THOMAS
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State | VI
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Zip | 00802-2612
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Country | US
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Telephone | 340-776-2544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11366
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City | ST THOMAS
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State | VI
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Zip | 00801-4366
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Country | US
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Telephone | 340-776-2544
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | EVETH VIALET
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Credential |
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Telephone | 340-776-2544
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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 |
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License Number State |
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