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General NPI Number Information
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NPI Number | 1649704065
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Entity Type | Organization
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Legal Business Name | BILTMORE DERMATOLOGY LLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 76 W SPRINGHILL DR
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City | TERRE HAUTE
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State | IN
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Zip | 47802-8767
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Country | US
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Telephone | 812-994-1404
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Fax | 844-262-4878
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Provider Business Mailing Address
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Address Line | PO BOX 3445
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-3445
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Country | US
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Telephone | 812-994-1404
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Fax | 844-262-4878
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Authorized Official
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Title or Position | OWNER
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Name | RYAN PATTERSON
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Credential | DCNP
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Telephone | 812-994-1404
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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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