Provider Demographics
NPI:1033655667
Name:MASSDERM BILLING PC
Entity Type:Organization
Organization Name:MASSDERM BILLING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-225-3376
Mailing Address - Street 1:900 CUMMINGS CTR
Mailing Address - Street 2:SUITE 311-T
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6198
Mailing Address - Country:US
Mailing Address - Phone:978-225-3376
Mailing Address - Fax:
Practice Address - Street 1:900 CUMMINGS CTR
Practice Address - Street 2:SUITE 311-T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6198
Practice Address - Country:US
Practice Address - Phone:978-225-3376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASSACHUSETTS DERMATOLOGY ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-06
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242892207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty