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Organization

DISTINCTIVE DERMATOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMBER ATWATER MD (MANAGER)
(919) 239-0126
Entity
Organization

Contact information

Practice address
8603 WESTWOOD CENTER DR STE 320, VIENNA, VA 22182-2230
(703) 570-1192
(703) 382-6654
Mailing address
PO BOX 64, GREAT FALLS, VA 22066-0064
(703) 570-1192

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
07/09/2024
Last updated
01/02/2025
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