INTEGRATED DERMATOLOGY OF GRANVILLE, LLC (NPI# 1609204908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609204908 |
| Entity Type | Organization |
| Organization Name | INTEGRATED DERMATOLOGY OF GRANVILLE, LLC |
| Practice Address |
1959 Newark Granville Rd Granville OH 43023-9171 |
| Mailing Address |
4700 Exchange Ct Ste 110 Boca Raton FL 33431-4450 |
| Practice Telephone | 7405870778 |
| Practice Fax Number | 7405870601 |
| Mailing Telephone | 5613142000 |
| Mailing Fax Number | 5613142000 |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | JEFFREY D. QUEEN (OWNER) |
| Authorized Official Telephone | 5613142000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
1959 NEWARK GRANVILLE RD |
| City | GRANVILLE |
| State | OH |
| Zip Code | 43023-9171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043409303 | Midwest Dermatology Centre LLC | Dermatology | 1959 Newark Granville Rd, Granville, OH 43023-9171 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114562543 | Healing Horizons Professional Counseling LLC | Counselor | 927 River Road, Granville, OH 43023 | 2019-11-08 |
| 1376109892 | Kadian Samantha Miracle | Psychologist | 100 West College Street, Whisler Hall, Granville, OH 43023 | 2019-05-10 |
| 1710331715 | Navin Muni | Family Medicine | 1264 Weaver Drive, Granville, OH 43023 | 2016-04-16 |
| 1316335268 | Derek Fry | Specialist/Technologist | 200 Livingston Dr, Granville, OH 43023 | 2014-12-30 |
| 1174880850 | Granville Township Trustees | Ambulance | 500 S. Main Street, Granville, OH 43023 | 2012-04-18 |
| 1700022639 | Mid-ohio Counseling, LLC | Community/Behavioral Health | 905a River Road, Granville, OH 43023 | 2008-12-24 |
| 1578718540 | Perry Franklin Watson IIi | Chiropractor | 119 South Prospect Street, Granville, OH 43023 | 2008-11-18 |
| 1053524611 | Eric Ross Winters | Specialist/Technologist | 200 Livingston Way, Denison University Department of Physical Education, Granville, OH 43023 | 2007-05-08 |
| 1699988659 | Lakeesha Nicole Leonard | Specialist/Technologist | Denison University Physical Education Department, 200 Livingston Dr, Granville, OH 43023 | 2007-05-07 |
| 1447386537 | Christopher D Avery | Dentist | 127 South Prospect St, Granville, OH 43023 | 2007-02-26 |
| Find all providers in zip 43023 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043409303 | Midwest Dermatology Centre LLC | Dermatology | 1959 Newark Granville Rd, Granville, OH 43023-9171 | 2007-10-23 |
| 1881745917 | Melinda Joann Woofter | Dermatology | 1959 Newark-granville Rd, Granville, OH 43023 | 2007-01-16 |
| 1619970639 | David Francis Geiss | Dermatology | 2000 Newark Granville Rd Ste 202, Granville, OH 43023-9135 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623808 | Bria Deshea Barjuca | Dermatology | 4450 Eastgate Blvd Ste 232, Cincinnati, OH 45245-1788 | 2020-09-09 |
| 1184263675 | Sunkiss Essentials LLC | Dermatology | 2926 State Rd Ste 369, Cuyahoga Falls, OH 44223-1244 | 2019-12-31 |
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1144737560 | Robert Brody Md Co | Dermatology | 3461 Warrensville Center Rd Ste 101, Shaker Heights, OH 44122-5227 | 2018-01-08 |
| 1366893752 | Kirsten Dickinson | Dermatology | Cleveland Clinic 9500 Euclin Ave, Cleveland, OH 44195-1009 | 2016-06-27 |
| 1649629692 | Megan Ashley Jones-sheets | Dermatology | 75 Metro Place North, Suite 195, Dublin, OH 43017 | 2016-06-10 |
| 1275982746 | Samantha N Barry | Dermatology | 9403 Kenwood Rd Ste B100, Blue Ash, OH 45242-6858 | 2016-06-06 |
| 1720433592 | Nitin Tiwari | Dermatology | 4439 State Route 159 Ste G50, Chillicothe, OH 45601-7202 | 2016-04-29 |
| 1487008751 | Kiyanna Marie Williams | Dermatology | 2049 E 100th St A Building, Cleveland, OH 44195-1014 | 2016-04-22 |
| 1336502038 | Jacqueline Graham | Dermatology | 566 White Pond Dr Ste E, Akron, OH 44320-1116 | 2016-03-30 |
| Find all providers with the same taxonomy | ||||
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| 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.