UNIVERSITY OF MARYLAND DERMATOLOGISTS PA
NPI 1104623867
Dermatology in Lutherville, MD

Q: What is University Of Maryland Dermatologists PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since February 28, 2025CLIA Certified · 4 labs

1447 YORK RD STE 102, LUTHERVILLE, MD 21093(667) 214-1171 Get Directions Write a Review

NPPES record last updated: February 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About University Of Maryland Dermatologists Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNIVERSITY OF MARYLAND DERMATOLOGISTS PA (NPI 1104623867) is a healthcare organization registered as a dermatology in Lutherville, Maryland and active in the NPI registry since February 2025. The organization holds 4 active CLIA laboratory certificates and lists Shavonda L Williams, Corporate Director Professional Fee, as its authorized official.

NPPES Registry Identity

NPI1104623867

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameUNIVERSITY OF MARYLAND DERMATOLOGISTS PA

Location Address1447 YORK RD STE 102Lutherville, MD 21093-6017

Mailing Address250 W Pratt St Ste 900Baltimore, MD 21201-6808

Phone(667) 214-1171

Organization SubpartNo

Authorized OfficialShavonda L WilliamsCorporate Director Professional Fee · (667) 214-2500

Enumeration DateFebruary 28, 2025

NPPES CertifiedFebruary 28, 2025

✔ NPI 1104623867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

1447 YORK RD STE 102, Lutherville, MD 21093

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 21D2321219

University Of Maryland Dermatology · Lutherville, MD

Active · expires Mar 25, 2028

CLIA Number21D2321219

Laboratory TypePhysician Office

Certificate Effective DateMarch 26, 2026

Certificate Expiration DateMarch 25, 2028

Laboratory DirectorZaineb Makhzoumi

Laboratory Phone(667) 214-1171

Laboratory LocationUniversity Of Maryland Dermatology1447 York Road Ste 102, Lutherville, MD 21093

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D2133919

University Of Maryland Dermatologists, PA · Baltimore, MD

Active · expires Jul 20, 2027

CLIA Number21D2133919

Laboratory TypePhysician Office

Certificate Effective DateJuly 21, 2025

Certificate Expiration DateJuly 20, 2027

Laboratory DirectorMarcia Driscoll

Laboratory Phone(667) 214-1171

Laboratory LocationUniversity Of Maryland Dermatologists, PA419 West Redwood Street Suite 260, Baltimore, MD 21201

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 21D2330830

University Of Maryland Dermatology · Ellicott City, MD

Active · expires Sep 22, 2027

CLIA Number21D2330830

Laboratory TypePhysician Office

Certificate Effective DateSeptember 23, 2025

Certificate Expiration DateSeptember 22, 2027

Laboratory DirectorZained Makhzoumi

Laboratory Phone(667) 214-1171

Laboratory LocationUniversity Of Maryland Dermatology6021 University Blvd Suite 390, Ellicott City, MD 21043

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D2133977

University Of Maryland Dermatology, PA · Columbia, MD

Active · expires Jul 23, 2027

CLIA Number21D2133977

Laboratory TypePhysician Office

Certificate Effective DateJuly 24, 2025

Certificate Expiration DateJuly 23, 2027

Laboratory DirectorMarcia Driscoll

Laboratory Phone(667) 214-1171

Laboratory LocationUniversity Of Maryland Dermatology, PA5890 Waterloo Road, Columbia, MD 21045

CLIA data matches this NPI record on: Phone

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLOTTE LANPHEAR

Physician Assistant (Medical)