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General NPI Number Information
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NPI Number | 1548692197
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Entity Type | Organization
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Legal Business Name | GANZER - HAHN DERMATOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 2101 CHAPLINE ST
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City | WHEELING
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State | WV
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Zip | 26003-3875
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Country | US
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Telephone | 304-233-3240
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 CHAPLINE ST
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City | WHEELING
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State | WV
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Zip | 26003-3875
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Country | US
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Telephone | 304-233-3240
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GREGORY GANZER
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Credential | DO
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Telephone | 304-233-3240
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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 | 992CW
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License Number State | WV
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