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).
| 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 |
| 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 |
| 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 |
| Street Address |
1985 JEFFERSON DAVIS HWY |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-5298 |
| 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 |
| 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 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| 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/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861695181 | Mark P. Eid | Dermatology | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 | 2007-06-06 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER.
| 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.