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NPI 1619538394

NPI 1619538394 : ESSENTIAL DERMATOLOGY BILH PLLC : NATICK, MA

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General NPI Number Information
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    NPI Number           |    1619538394
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    Entity Type          |    Organization 
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    Legal Business Name  |    ESSENTIAL DERMATOLOGY BILH PLLC 
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Dates
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    Enumeration Date     |    06/24/2019
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    Last Update Date     |    01/01/2026
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Provider Practice Location Address
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    Address Line         |    220 N MAIN ST STE 201 
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    City                 |    NATICK
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    State                |    MA
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    Zip                  |    01760-1100
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    Country              |    US
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    Telephone            |    508-545-9713
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    Fax                  |    508-827-2616
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Provider Business Mailing Address
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    Address Line         |    220 N MAIN ST STE 201 
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    City                 |    NATICK
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    State                |    MA
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    Zip                  |    01760-1100
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    Country              |    US
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    Telephone            |    
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    Fax                  |    508-827-2616
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Authorized Official
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    Title or Position    |    MANAGING MEMBER
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    Name                 |     MICHAEL SCOTT KRATHEN 
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    Credential           |    MD
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    Telephone            |    508-827-2615
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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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