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NPI Code Detail

MEDICARE: SOBERA DERMATOLOGY GROUP, PC

MEDICARE: SOBERA DERMATOLOGY GROUP, PC
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
1207N00000XDermatology Physician24170AL

General Provider Information

NPI Number : 1548437973
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOBERA DERMATOLOGY GROUP, PC
Provider Business Mailing Address
First Line : 2900 CAHABA RD
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-1937
Country : US
Telephone Number : 205-877-9773
Fax Number :
Provider Business Practice Location Address
First Line : 2900 CAHABA RD
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-1937
Country : US
Telephone Number : 205-877-9773
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JENNY SOBERA
Credential : MD
Telephone Number : 205-877-9773
Provider Enumeration Date : 05/14/2008
Last Update Date : 01/13/2015

Similar Medicare Providers

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Practice Location Address:
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Practice Fax: 205-877-9775
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1871930180 — DERM MEDS
Practice Location Address:
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Practice Fax:
1669897708 — CHERYL GUTHRIE PA-C
Practice Location Address:
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1598184566 — DR. RACHEL TEAT PFLEDERER MD
Practice Location Address:
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Practice Fax: 205-877-9775

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