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General NPI Number Information
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NPI Number | 1215061759
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DERMATOLOGY CENTER, P.C
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16220 S FREDERICK AVE SUITE 420
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City | GAITHERSBURG
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State | MD
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Zip | 20877-4039
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Country | US
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Telephone | 301-869-2126
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Fax | 301-869-2127
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Provider Business Mailing Address
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Address Line | 16220 S FREDERICK AVE SUITE 420
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City | GAITHERSBURG
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State | MD
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Zip | 20877-4039
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Country | US
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Telephone | 301-869-2126
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Fax | 301-869-2127
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. WAYNE XUE
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Credential | MD, PHD
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Telephone | 301-869-2126
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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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