Organization
UNIVERSITY HOSPITAL DERMATOLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BYRNE (PRACTICE ADMINISTRATOR)
(216) 844-8992
Entity
Organization
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1736
(216) 844-8200
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HEIGHTS, OH 44122-5203
(216) 286-6295
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2123642
—
OH
Enumeration date
05/19/2006
Last updated
08/13/2008
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