Organization
HIDRADENITIS SUPPURATIVA INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL G HAZEN M.D. (PRESIDENT)
(440) 249-0274
Entity
Organization
Contact information
Practice address
26908 DETROIT RD, SUITE 103, WESTLAKE, OH 44145-2398
(440) 249-0274
(440) 808-1606
Mailing address
26908 DETROIT RD, SUITE 103, WESTLAKE, OH 44145-2398
(440) 249-0274
(440) 808-1606
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
037749
OH
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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