Provider Demographics
NPI:1750495990
Name:DAVID A. HIGH
Entity Type:Organization
Organization Name:DAVID A. HIGH
Other - Org Name:ACCENT DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-953-0908
Mailing Address - Street 1:622 STOKES RD
Mailing Address - Street 2:STE A
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2913
Mailing Address - Country:US
Mailing Address - Phone:609-953-0908
Mailing Address - Fax:609-953-5978
Practice Address - Street 1:622 STOKES RD
Practice Address - Street 2:STE A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2913
Practice Address - Country:US
Practice Address - Phone:609-953-0908
Practice Address - Fax:609-953-5978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04723800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ049759Medicare ID - Type Unspecified
NJF00015Medicare UPIN