Organization
CAMDEN DERMATOLOGY & MOHS SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY ALLISON LAVIGNE MD FAAD FACMS (PRESIDENT)
(415) 802-1310
Entity
Organization
Contact information
Practice address
195 UNION ST, ROCKPORT, ME 04856-6107
(415) 802-1310
(207) 706-5030
Mailing address
195 UNION ST, ROCKPORT, ME 04856-6107
(415) 802-1310
(877) 343-6641
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215440011
—
ME
Enumeration date
11/15/2017
Last updated
02/25/2026
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