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General NPI Number Information
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NPI Number | 1770531238
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY PLUS, P.C.
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4515 SOUTHLAKE PKWY 203
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City | HOOVER
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State | AL
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Zip | 35244-3317
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Country | US
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Telephone | 205-988-3311
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Fax | 205-988-4050
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Provider Business Mailing Address
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Address Line | 4515 SOUTHLAKE PKWY 203
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City | HOOVER
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State | AL
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Zip | 35244-3317
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Country | US
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Telephone | 205-988-3311
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Fax | 205-988-4050
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANN K. GERLAD
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Credential | M.D.
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Telephone | 205-988-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4114
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License Number State | AL
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