MEDICARE: WARREN DERMATOLOGY AND MOHS SURGERY LLC.

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	35.099878	OH

General Provider Information

NPI Number	:	1033591813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN DERMATOLOGY AND MOHS SURGERY LLC.

Provider Business Mailing Address
First Line	:	1745 NILES CORTLAND ROAD NE SUITE 5
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484
Country	:	US
Telephone Number	:	330-856-6365
Fax Number	:	330-474-3981

Provider Business Practice Location Address
First Line	:	1745 NILES CORTLAND ROAD NE SUITE 5
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484
Country	:	US
Telephone Number	:	330-856-6365
Fax Number	:	330-474-3981

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. MORGAN E HOTT
Credential	:	MD
Telephone Number	:	330-856-6365

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	03/27/2026

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