Organization
DOWNTOWN DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI HICKS-GRAHAM M.D. (OWNER)
(614) 224-4566
Entity
Organization
Contact information
Practice address
500 E MAIN ST, SUITE 310, COLUMBUS, OH 43215-4741
(614) 224-4566
(614) 224-6046
Mailing address
500 E MAIN ST, SUITE 310, COLUMBUS, OH 43215-5369
(614) 224-4566
(614) 224-6046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35086908
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2778703
—
OH
Enumeration date
01/04/2008
Last updated
11/10/2009
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