Organization
PURE DERMATOLOGY & AESTHETICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SHANNON MARTIN MD (PHYSICIAN)
(205) 682-8022
Entity
Organization
Contact information
Practice address
5346 STADIUM TRACE PKWY, SUITE 100, HOOVER, AL 35244-4582
(205) 682-8022
Mailing address
5346 STADIUM TRACE PKWY, SUITE 100, HOOVER, AL 35244-4582
(205) 682-8022
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21915
AL
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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