Organization
TIDEWAY DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FRANKLIN JAFFE MD (OWNER)
(410) 939-0961
Entity
Organization
Contact information
Practice address
323 S UNION AVE, HAVRE DE GRACE, MD 21078-3201
(410) 939-0961
Mailing address
323 S UNION AVE, HAVRE DE GRACE, MD 21078-3201
(410) 939-0961
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0045614
MD
Other
Enumeration date
11/01/2006
Last updated
07/26/2016
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