Organization
PROVEN COSMETIC DERMATOLOGY
Active
Other names
Dermatology Aesthetics of Northern Kentucky
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN BUSHELMAN MD (OWNER)
(859) 802-4932
Entity
Organization
Contact information
Practice address
7766 EWING BLVD STE 100, FLORENCE, KY 41042-7538
(859) 283-1033
(859) 283-1066
Mailing address
7766 EWING BLVD STE 100, FLORENCE, KY 41042-7538
(859) 283-1033
(859) 283-1066
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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