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General NPI Number Information
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NPI Number | 1770912487
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Entity Type | Organization
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Legal Business Name | ACCESS DERMATOLOGY, PC
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Dates
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Enumeration Date | 11/03/2013
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Last Update Date | 11/03/2013
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Provider Practice Location Address
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Address Line | 563 NEFF AVE STE A
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City | HARRISONBURG
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State | VA
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Zip | 22801-3765
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Country | US
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Telephone | 540-214-9870
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Fax |
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Provider Business Mailing Address
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Address Line | 563 NEFF AVE STE A
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City | HARRISONBURG
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State | VA
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Zip | 22801-3765
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Country | US
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Telephone | 540-214-9870
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | MARY MATHER
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Credential | MD
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Telephone | 540-214-9870
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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 | 0101048850
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License Number State | VA
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