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Organization

ELEVATED MEDSPA CORP

Active
Other names
Elevated DermPath Corp, Indy Dermatology Inc., Elevated Dermatology & MedSpa Corp, Elevated Dermatology& MedSpa Corp, Lei Kay Med Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LARRY ZHAO MD, FCAP, FPAC, FACP (CEO, MD)
(317) 961-6396
Entity
Organization

Contact information

Practice address
8240 NAAB RD STE 360, INDIANAPOLIS, IN 46260-1987
(317) 961-6396
Mailing address
8240 NAAB RD STE 360, INDIANAPOLIS, IN 46260-1987
(317) 961-6396

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
171400000X
Health & Wellness Coach
175L00000X
Homeopath
207N00000X
Dermatology Physician
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
Primary
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NS0135X
Procedural Dermatology Physician
207SM0001X
Molecular Genetic Pathology (Medical Genetics) Physician
207ZC0500X
Cytopathology Physician
207ZP0101X
Anatomic Pathology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2083P0901X
Public Health & General Preventive Medicine Physician
261QR1100X
Research Clinic/Center
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
06/10/2021
Last updated
08/09/2021
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