Organization
SCOTTSDALE DERMATOLOGY AND COSMETIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G LEVINE MD (OWNER)
(303) 919-1131
Entity
Organization
Contact information
Practice address
10210 N 92ND ST STE 300, SCOTTSDALE, AZ 85258-4525
(480) 935-5999
(480) 935-5998
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
Other
Enumeration date
11/08/2017
Last updated
12/22/2017
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