MEDICARE: DERM ASSOCIATES 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	D0016370	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649271354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERM ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	10313 GEORGIA AVE
Second Line	:	SUITE 309
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-5006
Country	:	US
Telephone Number	:	301-681-7000
Fax Number	:	301-681-1040

Provider Business Practice Location Address
First Line	:	10313 GEORGIA AVE
Second Line	:	SUITE 309
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-5006
Country	:	US
Telephone Number	:	301-681-7000
Fax Number	:	301-681-1040

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NORMAN A LOCKSHIN
Credential	:	M.D.
Telephone Number	:	301-681-7000

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	03/27/2019

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Practice Location Address:

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Directions to “DERM ASSOCIATES LLC ” Practice Location

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