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Organization

MIDWEST DERMATOLOGY, LASER & VEIN CLINIC

Active
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Organization

MIDWEST DERMATOLOGY, LASER & VEIN CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGIE GLEASON (BILLING MANAGER)
(937) 875-2745
Entity
Organization

Contact information

Practice address
3006 N CO ROAD 25-A, TROY, OH 45373-1373
(937) 335-2075
(937) 339-0612
Mailing address
3006 N CO ROAD 25-A, TROY, OH 45373-1373
(937) 335-2075
(937) 339-0612

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary

Other

Enumeration date
03/05/2007
Last updated
04/09/2024
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