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General NPI Number Information
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NPI Number | 1407817539
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Entity Type | Individual
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Provider Name | DEBORAH W LOCKMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 3350 BERKMAR DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1491
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Country | US
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Telephone | 434-923-4651
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 BERKMAR DRIVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901
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Country | US
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Telephone | 434-923-4651
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Fax | 434-964-3636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0101054255
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 0101054255
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License Number State | VA
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