Organization
BRAVIA DERMATOLOGY GROUP, LLC
Active
Organization
BRAVIA DERMATOLOGY GROUP, LLC
Active
Other names
Bravia Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW A MOLENDA MD (OWNER)
(419) 948-3376
Entity
Organization
Contact information
Practice address
7050 SPRING MDWS DR W, HOLLAND, OH 43528-7203
(419) 948-3376
(419) 665-3632
Mailing address
7050 SPRING MDWS DR W, HOLLAND, OH 43528-7203
(419) 948-3376
(419) 665-3632
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
12/01/2016
Last updated
04/18/2024
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