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General NPI Number Information
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NPI Number | 1205108370
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Entity Type | Organization
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Legal Business Name | SKIN, PLLC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 2233 WISCONSIN AVE NW SUITE 230
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City | WASHINGTON
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State | DC
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Zip | 20007-4104
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Country | US
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Telephone | 202-298-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 2233 WISCONSIN AVE NW SUITE 230
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City | WASHINGTON
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State | DC
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Zip | 20007-4104
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Country | US
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Telephone | 202-298-7546
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | HOWARD L BROOKS
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Credential | M.D.
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Telephone | 202-298-7546
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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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