Organization
DERMATOLOGY AT THE LAKES PLLC
Active
Organization
DERMATOLOGY AT THE LAKES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BEEHLER MD (OWNER)
(415) 802-1310
Entity
Organization
Contact information
Practice address
1114 HIGHWAY 59 S STE 1, DETROIT LAKES, MN 56501-2204
(415) 802-1310
Mailing address
1114 HIGHWAY 59 S STE 1, DETROIT LAKES, MN 56501-2204
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56484
STATE LICENSE
MN
Enumeration date
10/16/2023
Last updated
06/17/2025
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