Organization
THE ARTS & SCIENCE OF DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON K DIVERS MD (PRESIDENT)
(540) 345-3556
Entity
Organization
Contact information
Practice address
4320 BRAMBLETON AVE, SUITE B, ROANOKE, VA 24018-3405
(540) 345-3556
(540) 342-2193
Mailing address
PO BOX 18237, ROANOKE, VA 24014-0824
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101231913
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184066
ANTHEM
VA
Enumeration date
07/12/2006
Last updated
07/27/2010
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