Provider Demographics
NPI:1609985514
Name:THE DERMATOLOGY AND SKIN CARE CENTER OF BIRMINGHAM, P.C.
Entity Type:Organization
Organization Name:THE DERMATOLOGY AND SKIN CARE CENTER OF BIRMINGHAM, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAPPALARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-978-3336
Mailing Address - Street 1:2470 ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243
Mailing Address - Country:US
Mailing Address - Phone:205-978-3336
Mailing Address - Fax:205-970-2397
Practice Address - Street 1:2470 ROCKY RIDGE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243
Practice Address - Country:US
Practice Address - Phone:205-978-3336
Practice Address - Fax:205-970-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH23558Medicare UPIN