Organization
DOCKSIDE DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLEY SUTHERLAND MD (OWNER)
(410) 533-4200
Entity
Organization
Contact information
Practice address
8601 VETERANS HWY STE 201, MILLERSVILLE, MD 21108-1566
(410) 934-5400
(410) 934-0141
Mailing address
8601 VETERANS HWY STE 201, MILLERSVILLE, MD 21108-1566
(410) 934-5400
(410) 934-0141
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
02/09/2022
Last updated
03/26/2023
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