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General NPI Number Information
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NPI Number | 1841370160
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Entity Type | Organization
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Legal Business Name | DESERT DERMATOLOGY OF YUMA INC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2741 S 8TH AVE A
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City | YUMA
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State | AZ
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Zip | 85364
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Country | US
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Telephone | 928-344-5771
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Fax | 928-344-6064
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Provider Business Mailing Address
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Address Line | 2741 S 8TH AVE A
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City | YUMA
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State | AZ
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Zip | 85364
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Country | US
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Telephone | 928-344-5771
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Fax | 928-344-6064
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN DIANE SLOMINSKI
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Credential | DO
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Telephone | 928-344-5771
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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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