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Organization

CLARKSBURG DERMATOLOGY AND SKINCARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHANNA FANGMEYER CRNP (OWNER)
(301) 298-1818
Entity
Organization

Contact information

Practice address
23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871
(301) 298-1818
(301) 540-1865
Mailing address
1136 OPAL CT, HAGERSTOWN, MD 21740-5940
(800) 430-6311
(240) 469-4836

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R134352
MD

Other

Enumeration date
05/30/2018
Last updated
07/12/2018
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