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General NPI Number Information
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NPI Number | 1407058324
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3201 W PEORIA AVE SUITE C-600
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City | PHOENIX
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State | AZ
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Zip | 85029-4608
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Country | US
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Telephone | 602-866-3344
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Fax | 602-375-2088
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Provider Business Mailing Address
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Address Line | 3201 W PEORIA AVE SUITE C-600
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City | PHOENIX
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State | AZ
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Zip | 85029-4608
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Country | US
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Telephone | 602-866-3344
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Fax | 602-375-2088
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVAN G BAUER
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Credential | M.D.
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Telephone | 602-866-3344
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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 | 13703
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License Number State | AZ
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