Provider Demographics
NPI:1952667677
Name:ACRI DERMATOLOGY, P.A.
Entity Type:Organization
Organization Name:ACRI DERMATOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ACRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-931-2274
Mailing Address - Street 1:8100 SANDPIPER CIRCLE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-931-2274
Mailing Address - Fax:410-931-2273
Practice Address - Street 1:8100 SANDPIPER CIRCLE
Practice Address - Street 2:SUITE 208
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4991
Practice Address - Country:US
Practice Address - Phone:410-931-2274
Practice Address - Fax:410-931-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057782207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH24764Medicare UPIN