Great Lakes Dermatology
Great Lakes Dermatology is a Procedural Dermatology Physician in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.
- Licensed in
- WI
- In the registry since
- 2007
Practice location Address checks out
3601 30th Ave Ste 210Kenosha, WI 53144-1695
Phone: (262) 658-2594
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Procedural Dermatology Physician (primary) | Taxonomy 207NS0135X (WI) |
|---|
Record details
| NPI number | 1558576322 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Cathy Dean — Administrator · (800) 485-8640 |
| NPI enumerated | May 14, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 3610 30th Avenue, Suite 210, Kenosha, WI 53144 |