Provider Demographics
NPI:1336680743
Name:ELEVATED DERMATOLOGY AND SKIN CANCER SURGERY CENTER, PC
Entity Type:Organization
Organization Name:ELEVATED DERMATOLOGY AND SKIN CANCER SURGERY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MESSANA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:720-851-5200
Mailing Address - Street 1:10345 PARKGLENN WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3883
Mailing Address - Country:US
Mailing Address - Phone:720-851-5200
Mailing Address - Fax:720-851-5222
Practice Address - Street 1:10345 PARKGLENN WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3883
Practice Address - Country:US
Practice Address - Phone:720-851-5200
Practice Address - Fax:720-851-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0057198207N00000X, 207ND0101X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty