Organization
EPIPHANY DERMATOLOGY OF MINNESOTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (VICE PRESIDENT)
(512) 960-5760
Entity
Organization
Contact information
Practice address
2718 EKKO AVE, ALBERT LEA, MN 56007-1800
(507) 373-2270
(507) 373-0363
Mailing address
7300 RANCH RD. 2222, BLDG 1, STE 200, AUSTIN, TX 78730-2309
(512) 628-0465
(512) 628-0468
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
10/13/2006
Last updated
06/09/2025
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