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Petersburg Dermatology, Pc
Medical Specialty Clinic/Center in Petersburg, Virginia
NPI 1740435650

Petersburg Dermatology, Pc is a Medical Specialty Clinic/Center based in Petersburg, VA and is specialized in Medical Specialty. Petersburg Dermatology, Pc practices in Petersburg, VA. The NPI Number for Petersburg Dermatology, Pc is 1740435650 and holds a License No. 0101052210 (Virginia).

The current practice location address for Petersburg Dermatology, Pc is 3277 S Crater Rd, Petersburg, VA and can be reached out via phone at 804-861-5555 and via fax at 804-861-5500.

Location: 3277 S Crater Rd, Petersburg, VA, 23805-9285
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740435650
Provider Name
Petersburg Dermatology, Pc
Credential
Provider Entity Type
Organization
Address
3277 S Crater Rd, Petersburg, VA, 23805-9285
Phone Number
804-861-5555
Fax Number
804-861-5500
Provider Enumeration Date
11/19/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
005900972 05 VA
institution
Provider Business Practice Location Address Details
Address
3277 S Crater Rd
City
Petersburg
State
Virginia
Zip
23805-9285
Phone Number
804-861-5555
Fax Number
804-861-5500
person
Provider Business Mailing Address Details
Address
3277 S Crater Rd
City
Petersburg
State
Virginia
Zip
23805-9285
Phone Number
804-861-5555
Fax Number
804-861-5500
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
0101052210 (Virginia)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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