Individual
CRAIG DEAN OMOHUNDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20605
AL
207ND0101X
MOHS-Micrographic Surgery Physician
20605
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000032376
—
AL
05
—
00749185A
—
GA
05
—
255070900
—
FL
Enumeration date
09/13/2005
Last updated
10/22/2015
Update your record
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