Organization
LAKEWOOD DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE D NEIDER M.D. (OWNER/PHYSICIAN)
(216) 458-0322
Entity
Organization
Contact information
Practice address
14701 DETROIT AVE, SUITE 208, LAKEWOOD, OH 44107-4115
(216) 458-0322
(216) 458-0325
Mailing address
14701 DETROIT AVE, SUITE 208, LAKEWOOD, OH 44107-4115
(216) 458-0322
(216) 458-0325
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35081781
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065021
—
OH
Enumeration date
09/03/2014
Last updated
09/03/2014
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