Organization
AVENUES DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA S PHIEFFER MD (OWNER)
(804) 288-4410
Entity
Organization
Contact information
Practice address
420 LIBBIE AVE, RICHMOND, VA 23226-2616
(804) 288-4410
(804) 288-4458
Mailing address
420 LIBBIE AVE, RICHMOND, VA 23226-2616
(804) 288-4410
(804) 288-4458
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0101059025
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1229850
HMO
VA
01
—
187989
ANTHEM
VA
01
—
7229207
NON-HMO
VA
Enumeration date
03/27/2007
Last updated
10/25/2013
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