Provider Demographics
NPI:1578805677
Name:UNIVERSAL DERMATOLOGY, LTD
Entity Type:Organization
Organization Name:UNIVERSAL DERMATOLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKANDAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-602-6455
Mailing Address - Street 1:425 METRO PL N
Mailing Address - Street 2:SUITE 195
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5325
Mailing Address - Country:US
Mailing Address - Phone:614-602-6455
Mailing Address - Fax:614-259-9944
Practice Address - Street 1:425 METRO PL N
Practice Address - Street 2:SUITE 195
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5325
Practice Address - Country:US
Practice Address - Phone:614-602-6455
Practice Address - Fax:614-259-9944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35091957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty