Provider Demographics
NPI:1245693936
Name:DERMDOX DERMATOLOGY CENTERS PC
Entity type:Organization
Organization Name:DERMDOX DERMATOLOGY CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHLEICHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-459-0029
Mailing Address - Street 1:8 BROOKHILL SQUARE SOUTH
Mailing Address - Street 2:2A
Mailing Address - City:SUGARLOAF
Mailing Address - State:PA
Mailing Address - Zip Code:18249-1010
Mailing Address - Country:US
Mailing Address - Phone:570-459-0029
Mailing Address - Fax:570-454-5757
Practice Address - Street 1:8 BROOKHILL SQUARE SOUTH
Practice Address - Street 2:2A
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249-1010
Practice Address - Country:US
Practice Address - Phone:570-459-0029
Practice Address - Fax:570-454-5757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019757E207N00000X
207ND0101X, 213E00000X, 363A00000X, 363L00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty