Northern Indiana Dermatology and Skin Surgery Center
Northern Indiana Dermatology and Skin Surgery Center is an MOHS-Micrographic Surgery Physician in Portage, Indiana. Licensed in Indiana. Registered with an NPI since 2006.
- Licensed in
- IN
- In the registry since
- 2006
Practice location Address checks out
3190 Lancer StPortage, IN 46368-4488
Phone: (219) 764-3600
Fax: (219) 764-3661
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| MOHS-Micrographic Surgery Physician (primary) | Taxonomy 207ND0101X · Licence 207N00000X (IN) |
|---|
Record details
| NPI number | 1639289093 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ruchik Desai — Physician · (219) 764-3600 |
| NPI enumerated | August 30, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 3190 Lancer St, Portage, IN 46368-4488 |