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Organization

DERMATOLOGY OF PHILADELPHIA / MOHS SURGERY CENTER, LLC

Active
Other names
Dermatology of Philadelphia / Mohs Surgery Center, Dermatology of Philadelphia, Mohs Surgery Center, Center for Transplant Patients
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK ABDELMALEK MD (OWNER)
(215) 990-6788
Entity
Organization

Contact information

Practice address
200 N 16TH ST STE D, PHILADELPHIA, PA 19102-1225
(215) 315-3197
Mailing address
200 N 16TH ST STE D, PHILADELPHIA, PA 19102-1225

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
207ND0900X
Dermatopathology Physician
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
10/07/2019
Last updated
02/12/2021
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