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General NPI Number Information
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NPI Number | 1881168615
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Entity Type | Organization
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Legal Business Name | CITY DERMATOLOGY, LLC
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 5632 ANNAPOLIS RD STE 4
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City | BLADENSBURG
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State | MD
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Zip | 20710-2213
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Country | US
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Telephone | 301-233-0243
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Fax |
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Provider Business Mailing Address
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Address Line | 13623 BALTIMORE AVE
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City | LAUREL
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State | MD
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Zip | 20707-5095
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC ZHANG
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Credential | DNP
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Telephone | 301-233-0243
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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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