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General NPI Number Information
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NPI Number | 1407035165
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Entity Type | Organization
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Legal Business Name | CHEVY CHASE DERMATOLOGY, LLC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 08/10/2008
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Provider Practice Location Address
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Address Line | 5530 WISCONSIN AVE STE 830
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4461
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Country | US
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Telephone | 301-656-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 5530 WISCONSIN AVE STE 830
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4461
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Country | US
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Telephone | 301-656-7546
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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 | DR. MARGARET LITWIN SOMMERVILLE
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Credential | M.D.
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Telephone | 301-656-7546
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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 | D0061245
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License Number State | MD
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