Organization
SKIN VEIN & COSMETIC SURGERY CLINIC PC
Active
Organization
SKIN VEIN & COSMETIC SURGERY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD FATHI MD (PRESIDENT)
(219) 836-4343
Entity
Organization
Contact information
Practice address
9130 COLUMBIA AVE, SUITE A, MUNSTER, IN 46321
(219) 836-4343
(219) 836-4387
Mailing address
9130 COLUMBIA AVE, SUITE A, MUNSTER, IN 46321
(219) 836-4343
(219) 836-4387
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01029379A
IN
Other
Enumeration date
09/20/2006
Last updated
12/09/2011
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