Organization
ASMSC-VALPARAISO IN PC
Active
Organization
ASMSC-VALPARAISO IN PC
Active
Other names
Advanced Skin and Mohs Surgery Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE W BROWN JR. MD, JD (OWNER, CEO, PRESIDENT)
(269) 985-0021
Entity
Organization
Contact information
Practice address
6445 E DIVISION RD, MILL CREEK, IN 46365-9798
(269) 985-0021
Mailing address
2570 NILES RD, SAINT JOSEPH, MI 49085-3203
(269) 985-0021
(269) 281-0281
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
208200000X
Plastic Surgery Physician
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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