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Organization

CHARTER DERMATOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SURESH KUMAR MENON M.D. (PHYSICIAN PARTNER)
(301) 693-3336
Entity
Organization

Contact information

Practice address
1008 TAVERN RD STE 201, MARTINSBURG, WV 25401-2859
(301) 693-3336
Mailing address
1800 LATIGO CT, FREDERICK, MD 21702-5507
(301) 693-3336

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician

Other

Enumeration date
09/22/2023
Last updated
03/06/2024
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