Organization
FIFE DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA I LEE (CREDENTIALING MANAGER)
(702) 798-3008
Entity
Organization
Contact information
Practice address
1736 W. HORIZON RIDGE PARKWAY, HENDERSON, NV 89012
(702) 255-6647
(702) 933-1444
Mailing address
6460 MEDICAL CENTER STREET STE 350, LAS VEGAS, NV 89148-2423
(702) 255-6647
(702) 933-1444
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
12/13/2018
Last updated
12/18/2018
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