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NPI Code Detail

MEDICARE: HUNTINGTON DERMATOLOGY, INC.

MEDICARE: HUNTINGTON DERMATOLOGY, INC.
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
1174400000XSpecialistWV 08782WV

General Provider Information

NPI Number : 1376621144
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUNTINGTON DERMATOLOGY, INC.
Provider Business Mailing Address
First Line : 1321 HAL GREER BLVD
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-3803
Country : US
Telephone Number : 304-523-5100
Fax Number : 304-523-1750
Provider Business Practice Location Address
First Line : 1321 HAL GREER BLVD
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-3803
Country : US
Telephone Number : 304-523-5100
Fax Number : 304-523-1750
Authorized Official
Title or Position : PRESIDENT
Name : NAZEM ABRAHAM
Credential : MD
Telephone Number : 304-523-5100
Provider Enumeration Date : 11/01/2006
Last Update Date : 12/19/2007

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Directions to “HUNTINGTON DERMATOLOGY, INC. ” Practice Location

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