Provider Demographics
NPI:1770531238
Name:DERMATOLOGY PLUS, P.C.
Entity type:Organization
Organization Name:DERMATOLOGY PLUS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:GERLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-988-3311
Mailing Address - Street 1:4515 SOUTHLAKE PKWY
Mailing Address - Street 2:203
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3317
Mailing Address - Country:US
Mailing Address - Phone:205-988-3311
Mailing Address - Fax:205-988-4050
Practice Address - Street 1:4515 SOUTHLAKE PKWY
Practice Address - Street 2:203
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3317
Practice Address - Country:US
Practice Address - Phone:205-988-3311
Practice Address - Fax:205-988-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78718Medicare ID - Type Unspecified