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Organization

FAMILY DERMATOLOGY OF PENNSYLVANIA, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAULA M. NELSON MD (OWNER)
(215) 483-3666
Entity
Organization

Contact information

Practice address
6 HEARTHSTONE CT, SUITE 101, READING, PA 19606-3065
(610) 779-7773
(610) 779-7775
Mailing address
629 BEAVER RUIN RD NW, SUITE B, LILBURN, GA 30047-3468
(770) 921-4300
(770) 381-6451

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102386765-0001
PA
Enumeration date
08/08/2006
Last updated
09/23/2014
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