Provider Demographics
NPI:1477227361
Name:DERMPLUS
Entity Type:Organization
Organization Name:DERMPLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KASHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-477-9495
Mailing Address - Street 1:999 S. KENMORE
Mailing Address - Street 2:STE A
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714
Mailing Address - Country:US
Mailing Address - Phone:812-477-9495
Mailing Address - Fax:812-477-0134
Practice Address - Street 1:999 S. KENMORE
Practice Address - Street 2:STE A
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714
Practice Address - Country:US
Practice Address - Phone:812-477-9495
Practice Address - Fax:812-477-0134
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DERMPLUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty