Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI Number | 1053619098 |
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| LBN Legal business name | ALPINE DERMATOLOGY, LLC | ||||
| Authorized official | KRIS MILLER - (PHYSICIAN ASSISTANT CERTIFIED) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/28/2011 | ||||
| Last updated | 06/14/2023 - About 3 years ago | ||||
| Identifiers |
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