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General NPI Number Information
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NPI Number | 1598493629
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Entity Type | Organization
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Legal Business Name | CAREFREE DERMATOLOGY PC
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 7208 E CAVE CREEK ROAD UNIT E
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City | CAVE CREEK
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State | AZ
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Zip | 85331
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Country | US
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Telephone | 480-885-3377
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Fax | 480-885-3376
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Provider Business Mailing Address
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Address Line | 7208 E CAVE CREEK ROAD UNIT E
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City | CAVE CREEK
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State | AZ
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Zip | 85331
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Country | US
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Telephone | 480-885-3377
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Fax | 480-885-3376
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN KALLAL
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Credential | MD
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Telephone | 480-885-3377
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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 |
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License Number State |
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