Organization
DERMATOLOGY AND DERMATOLOGY SURGERY OF MOBILE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA SWAIN MD (OWNER)
(251) 414-5810
Entity
Organization
Contact information
Practice address
3153 DAUPHIN ST, MOBILE, AL 36606-4061
(251) 445-8888
(251) 479-7164
Mailing address
3153 DAUPHIN ST, MOBILE, AL 36606-4061
(251) 445-8888
(251) 479-7164
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510G70048
MEDICARE
AL
01
—
51594108
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
10/03/2008
Last updated
11/24/2015
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