MEDICARE: CORE DERMATOLOGY, PLLC

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	:	1790255313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE DERMATOLOGY, PLLC

Provider Business Mailing Address
First Line	:	4500 E CHERRY CREEK SOUTH DR STE 600
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-1500
Country	:	US
Telephone Number	:	303-355-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 E CHERRY CREEK SOUTH DR STE 600
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-1500
Country	:	US
Telephone Number	:	303-355-3000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LEAH FRANKEL
Credential	:	MD
Telephone Number	:	312-498-6653

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	09/20/2024

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