MEDICARE: FIXLER 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
1	207N00000X	Dermatology Physician	35019343	OH

General Provider Information

NPI Number	:	1801064522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIXLER DERMATOLOGY, INC.

Provider Business Mailing Address
First Line	:	231 MAIN ST
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1123
Country	:	US
Telephone Number	:	513-831-3003
Fax Number	:	513-831-3178

Provider Business Practice Location Address
First Line	:	231 MAIN ST
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1123
Country	:	US
Telephone Number	:	513-831-3003
Fax Number	:	513-831-3178

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ZELMAN CHARLES FIXLER
Credential	:	M.D.
Telephone Number	:	513-831-3003

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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