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Contact Information

NORTHSIDE DERMATOLOGY, LLC
9865 E 116TH ST STE 200
FISHERS, IN46037-9238
 Phone: 317-849-6600
 Fax: 317-849-6601
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for NORTHSIDE DERMATOLOGY LLC · (Female)

NPI Number 1710951165
Status Active
Credentials
Entity Individual
Enumeration date 02/14/2006
Last updated 02/26/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 01055268A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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