Organization
PREMIER DERMATOLOGY
Active
Other names
Panzer Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MARYPAT KWOKA MSM (PRACTICE ADMINISTRATOR)
(302) 633-7550
Entity
Organization
Contact information
Practice address
537 STANTON CHRISTIANA RD, SUITES 107,111,207 & 209, NEWARK, DE 19713-2146
(302) 633-7550
Mailing address
537 STANTON CHRISTIANA RD, SUITES 107,111,207 & 209, NEWARK, DE 19713-2146
(302) 633-7550
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C5-0001054
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5-0001054
DIVISION OF PROFESSIONAL REGULATION LICENSE
DE
Enumeration date
04/19/2016
Last updated
04/19/2016
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