VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER


Address: 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298
Phone: 5403736647

VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER (NPI# 1598056582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598056582
Entity Type Organization
Organization Name VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER
Practice Address 1985 Jefferson Davis Hwy
Fredericksburg
VA 22401-5298
Mailing Address 1985 Jefferson Davis Hwy
Fredericksburg
VA 22401-6233
Practice Telephone 5403736647
Practice Fax Number 5404791656
Mailing Telephone 5403736647
Mailing Fax Number 5404791656
Enumeration Date 2011-04-25
Last Update Date 2020-06-01
Authorized Official Name MARK P. EID (MEDICAL DIRECTOR)
Authorized Official Telephone 5403736647
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207ND0900X Dermatology
Specialization: Dermatopathology
Allopathic & Osteopathic Physicians
Y 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
0101249163 VA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
13875 Hedgewood Dr, Woodbridge, VA 221937930 5403736647 5404791656
385 Garrisonville Rd Ste 205, Stafford, VA 225541599 5403736647 5404791656
2616 Sherwood Hall Ln Ste 306, Alexandria, VA 223063154 5403736647 5404791656
1982 Opitz Blvd, Woodbridge, VA 221913304 5403736647 5404791656

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities Virginia Dermatology and Skin Surgery Center PLLC 1985 Jefferson Davis Hwy, Fredericksburg, Virginia 22401

Office Location

Street Address 1985 JEFFERSON DAVIS HWY
City FREDERICKSBURG
State VA
Zip Code 22401-5298

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548475189 Connor A Patterson Dermatology 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2007-05-14
1437686375 Kristen Helene Keller Physician Assistant 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2017-05-22
1023497880 Jalal Alghabra Physician Assistant 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2015-05-27
1740673250 Leah Waller Physician Assistant 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2015-03-07
1558653725 John Eric Jackson Dermatology 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2011-05-06
1861695181 Mark P. Eid Dermatology 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 2007-06-06
1487855680 Kim D Edhegard Dermatology 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 2007-05-29

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992313415 Amanda Dodd Behavior Technician 1411 Princess Anne, Fredericksburg, VA 22401 2020-07-21
1215567326 Britteny Whitaker Behavior Technician 1411 Princess Ann, Fredericksburg, VA 22401 2020-01-17
1396389433 Ashley Stanevich Behavior Technician 1411 Princess Anne Lane, Fredericksburg, VA 22401 2019-11-01
1265074231 Anna Kelleher Behavior Technician 1411 Princess Anna St, Frericksburg, VA 22401 2019-10-11
1649824152 Zaan Z Ali Audiologist 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 2019-08-01
1790342426 Michael Williams Jr. Physician Assistant 411 B Park Hill Dr, Frederickburg, VA 22401 2019-05-29
1285290965 Ann Damalie Namabiro Behavior Technician 1411 Princess Ann Street, Fredericksburg, VA 22401 2019-05-17
1922579630 Primary and Urgent Care LLC Family Medicine Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 2018-12-07
1003323056 Mariah Mazzariello Behavior Technician 1411 Princess Anne Stree, Fredericksburg, VA 22401 2017-12-29
1336655281 Hina Zafar Behavior Technician 1411 Princess Anne St., Fredericksburg, VA 22401 2017-12-14
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Taxonomy Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861695181 Mark P. Eid Dermatology 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 2007-06-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578129599 Metro Mohs Surgery Center, LLC Dermatology 5501 Backlick Rd Ste 120, Springfield, VA 22151-3940 2019-05-15
1699927129 Harry Leslie Parlette IIi Dermatology 125 Terrell Rd E, Charlottesville, VA 22901-2166 2008-10-15
1578722260 Soonyou Kwon Dermatology 8100 Boone Blvd Ste 300, Vienna, VA 22182-2642 2008-06-06
1457483869 Martha L Wilson Md Pa Dermatology 104 E Stuart Dr, Galax, VA 24333-2119 2007-03-12
1669561791 Advanced Dermatology of Charlottesville, Plc Dermatology 600 Peter Jefferson Parkway Suite 350, Charlottesville, VA 22911 2006-10-12
1063524593 Oyster Point Dermatology Inc Dermatology 11844 Rock Landing Dr Ste B, Newport News, VA 23606-4202 2006-08-31
1275586190 Amir Bajoghli Dermatology 1359 Beverly Rd, Suite 200, Mc Lean, VA 22101-3666 2006-05-19
1568441897 Dermatologic Surgery of Central Virginia Plc Dermatology 902 E Jefferson St, Suite 201, Charlottesville, VA 22902-5397 2006-01-13
1003440355 Absolute Dermatology P.C. Dermatology 5207 Hickory Park Dr Ste A, Glen Allen, VA 23059-2624 2020-02-26
1053944652 Forefront Dermatology, S.c. Dermatology 101 Candlewood Ct, Lynchburg, VA 24502-2654 2020-02-21
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Competitor

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City FREDERICKSBURG
Zip Code 22401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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