Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dermatology Professionals, PA

Organization MOHS-Micrographic Surgery Physician · NPI 1467169979

Dermatology Professionals, PA is an MOHS-Micrographic Surgery Physician in Grand Rapids, Minnesota. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1749 SE 2nd Ave
Grand Rapids, MN 55744-2576
Phone: (218) 454-7546
Fax: (218) 454-0390
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X

Record details

NPI number1467169979
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Lundstrom — President · (218) 454-7546
NPI enumeratedNovember 3, 2022
Last updated in NPPESJune 12, 2024
Certification dateJune 12, 2024
Mailing address13359 Isle Dr Ste 3, Baxter, MN 56425-2223