Organization
MANSFIELD DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH LYNNE MORITZ MD (OWNER)
(419) 756-5739
Entity
Organization
Contact information
Practice address
161 CLINE AVENUE, MANSFIELD, OH 44907
(419) 756-5739
(419) 756-4968
Mailing address
PO BOX 543, LEWIS CENTER, OH 43035
(740) 549-2596
(740) 549-0047
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35054857M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0856720
—
OH
Enumeration date
10/02/2006
Last updated
08/22/2020
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