Organization
ECKER DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP MARKS ECKER MD (CEO)
(952) 222-8149
Entity
Organization
Contact information
Practice address
1905 WAYZATA BLVD STE 240, WAYZATA, MN 55391-5006
(952) 222-8149
(262) 240-6257
Mailing address
1905 WAYZATA BLVD STE 240, WAYZATA, MN 55391-5006
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
11/03/2023
Last updated
06/11/2024
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