MEDICARE: DERMATOLOGY & SKIN CARE ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1033444997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMATOLOGY & SKIN CARE ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 9110
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-9110
Country	:	US
Telephone Number	:	513-770-3263
Fax Number	:	513-770-3295

Provider Business Practice Location Address
First Line	:	7249 LIBERTY WAY STE 100
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1704
Country	:	US
Telephone Number	:	513-770-3263
Fax Number	:	513-770-3295

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELIZABETH A. L. MUENNICH
Credential	:	M.D., PH.D.
Telephone Number	:	513-770-3263

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	08/01/2024

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