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Organization

SOUTH END SKIN CARE, INC.

Active
Other names
South End Dermatology and Skin Care, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARL F. SCHANBACHER M.D. (PRESIDENT)
(857) 362-7330
Entity
Organization

Contact information

Practice address
321 COLUMBUS AVENUE, SUITE 2R, BOSTON, MA 02116-5114
(857) 362-7330
(857) 362-7332
Mailing address
321 COLUMBUS AVENUE, SUITE 2R, BOSTON, MA 02116-5114
(857) 362-7330
(857) 362-7332

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207NS0135X
Procedural Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005608
MEDICARE PTAN
MA
Enumeration date
02/05/2008
Last updated
08/05/2008
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