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Organization

AESTHETIC DERMATOLOGY AND MOHS SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADAM JON TINKLEPAUGH MD (DERMATOLOGIST/OWNER)
(571) 529-5600
Entity
Organization

Contact information

Practice address
2826 OLD LEE HWY STE 150, FAIRFAX, VA 22031-4323
(571) 529-5600
(571) 529-5656
Mailing address
2826 OLD LEE HWY STE 150, FAIRFAX, VA 22031-4323
(571) 529-5600
(571) 529-5656

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
08/21/2023
Last updated
10/31/2024
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