Organization
ACADEMY DERMATOLOGISTS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (CEO)
(512) 960-5760
Entity
Organization
Contact information
Practice address
6648 E CARONDELET DR, TUCSON, AZ 85710-2119
(520) 886-8151
(520) 885-1404
Mailing address
6601 VAUGHT RANCH RD STE 200, AUSTIN, TX 78730-2309
(512) 628-0465
(512) 628-0468
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
RN081679
AZ
207NS0135X
Procedural Dermatology Physician
Primary
11617
AZ
Other
Enumeration date
04/27/2012
Last updated
02/28/2018
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