Provider Demographics
NPI:1134698103
Name:GLOBAL DERMATOLOGY, INC.
Entity type:Organization
Organization Name:GLOBAL DERMATOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICKOLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:POULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-505-0105
Mailing Address - Street 1:711 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2208
Mailing Address - Country:US
Mailing Address - Phone:719-505-0105
Mailing Address - Fax:833-428-9482
Practice Address - Street 1:711 N TAYLOR ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2208
Practice Address - Country:US
Practice Address - Phone:970-641-3927
Practice Address - Fax:833-428-9482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty