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General NPI Number Information
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NPI Number | 1265759013
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Entity Type | Organization
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Legal Business Name | SKIN CANCER AND DERMATOLOGY OF COLUMBUS, LLC
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 1161 BETHEL RD SUITE 301
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City | COLUMBUS
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State | OH
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Zip | 43220-2773
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Country | US
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Telephone | 614-459-5227
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 BETHEL RD SUITE #301
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City | COLUMBUS
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State | OH
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Zip | 43220-2773
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Country | US
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Telephone | 614-459-5227
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL CHEN
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Credential | M.D.
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Telephone | 614-459-5227
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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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