Provider Demographics
NPI:1497733570
Name:DANVILLE DERMATOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DANVILLE DERMATOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-792-3818
Mailing Address - Street 1:990 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1802
Mailing Address - Country:US
Mailing Address - Phone:434-792-3818
Mailing Address - Fax:434-792-8244
Practice Address - Street 1:990 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1802
Practice Address - Country:US
Practice Address - Phone:434-792-3818
Practice Address - Fax:434-792-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty