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Contact Information

CLARKSBURG DERMATOLOGY AND SKINCARE LLC
23202 BREWERS TAVERN WAY
CLARKSBURG, MD20871
 Phone: 301-298-1818
 Fax: 301-540-1865
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CLARKSBURG DERMATOLOGY AND SKINCARE LLC

NPI Number 1316439078
LBN Legal business name CLARKSBURG DERMATOLOGY AND SKINCARE LLC
Authorized official JOHANNA FANGMEYER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/30/2018
Last updated 07/12/2018 - About 8 years ago
Identifiers
MD License # R134352
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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