Organization
ADVANCED DERMATOLOGY OF EAST TENNESSEE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS DAVID SLAWSKY M.D. (PRESIDENT)
(865) 380-9300
Entity
Organization
Contact information
Practice address
615 SMITHVIEW DR, MARYVILLE, TN 37803-6100
(865) 380-9300
(865) 380-1558
Mailing address
615 SMITHVIEW DR, MARYVILLE, TN 37803-6100
(865) 380-9300
(865) 380-1558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD0000026250
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3091975
—
TN
01
—
3144148
BCBS PROVIDER NUMBER
TN
01
—
4619423
AETNA US HEALTHCARE
TN
Enumeration date
08/13/2006
Last updated
08/22/2020
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