Organization
PETERSBURG DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERICK JEAN FREIHOFER MD (PRESIDENT)
(804) 861-5555
Entity
Organization
Contact information
Practice address
3277 S CRATER RD, PETERSBURG, VA 23805-9285
(804) 861-5555
(804) 861-5500
Mailing address
3277 S CRATER RD, PETERSBURG, VA 23805-9285
(804) 861-5555
(804) 861-5500
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0101052210
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005900972
—
VA
Enumeration date
11/19/2008
Last updated
11/19/2008
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