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Contact Information

DERMATOLOGY CONSULTANTS OF GLOUCESTER P L L C
6790 WOOD RIDGE DRIVE
GLOUCESTER COURTHOUSE, VA23061
 Phone: 804-693-6527
 Fax: 804-693-6615
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for DERMATOLOGY CONSULTANTS OF GLOUCESTER P L L C · (Female)

NPI # 1568674133
Status Active
Credentials
Entity Individual
Enumeration date 05/04/2007
Last updated 06/07/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0101026776
  • VA Other 141598 ANTHEM BCBS GROUP NUMBER
  • VA Other CJ9476 RAILROAD MEDICARE
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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