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General NPI Number Information
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NPI Number | 1427805175
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Entity Type | Organization
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Legal Business Name | CRONIN DERMATOLOGY & SKIN CANCER CENTER OF KENT ISLAND, LLC
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Dates
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Enumeration Date | 05/01/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1630 MAIN ST STE 204
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City | CHESTER
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State | MD
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Zip | 21619-2793
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Country | US
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Telephone | 304-685-3629
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 MAIN ST STE 204
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City | CHESTER
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State | MD
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Zip | 21619-2793
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Country | US
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Telephone | 304-685-3629
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MEMBER
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Name | HYLAND CRONIN
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Credential | MD
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Telephone | 304-685-3629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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