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General NPI Number Information
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NPI Number | 1295165025
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Entity Type | Organization
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Legal Business Name | WESTMINSTER DERMATOLOGY, LLC
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 01/11/2014
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Provider Practice Location Address
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Address Line | 410 MEADOW CREEK DR SUITE 209
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City | WESTMINSTER
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State | MD
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Zip | 21158-9426
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Country | US
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Telephone | 410-596-8609
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Fax |
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Provider Business Mailing Address
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Address Line | 306 JASONTOWN RD
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City | WESTMINSTER
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State | MD
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Zip | 21158-3548
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Country | US
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Telephone | 410-596-8609
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BRENDA SCHNEIDER
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Credential | P.A.-C
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Telephone | 410-596-8609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0002810
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License Number State | MD
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