Organization
UNIVERSITY DERMATOLOGY CONSULTANTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENA ALEX (DIRECTOR OF BILLING OPERATIONS)
(513) 245-3066
Entity
Organization
Contact information
Practice address
222 PIEDMONT AVE, SUITE 5300, CINCINNATI, OH 45219-4231
(513) 475-7630
(513) 475-7636
Mailing address
PO BOX 631629, CINCINNATI, OH 45263-1629
(513) 245-3060
(513) 245-3070
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0781882
—
OH
Enumeration date
05/20/2006
Last updated
10/26/2010
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