NORTHERN INDIANA DERMATOLOGY AND SKIN SURGERY CENTER - NPI 1639289093

Q: What is Northern Indiana Dermatology And Skin Surgery Center's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

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About Northern Indiana Dermatology And Skin Surgery Center NPPES

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

NORTHERN INDIANA DERMATOLOGY AND SKIN SURGERY CENTER (NPI 1639289093) is a healthcare organization registered as a mohs-micrographic surgery in Portage, Indiana and active in the NPI registry since August 2006. The organization lists Ruchik S Desai, Physician, as its authorized official.

NPPES Registry Identity

NPI1639289093

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameNORTHERN INDIANA DERMATOLOGY AND SKIN SURGERY CENTER

Location Address3190 LANCER STPortage, IN 46368-4488

Mailing Address3190 Lancer StPortage, IN 46368-4488 · (219) 764-3600 · Fax (219) 764-3661

Phone(219) 764-3600

Fax(219) 764-3661

Organization SubpartNo

Authorized OfficialRuchik S DesaiPhysician · (219) 764-3600

Enumeration DateAugust 30, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1639289093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in IN · 207N00000X

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

3190 LANCER ST, Portage, IN 46368

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Other Identifiers 1

Other000000350979IN · Anthem

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

MARLEE R PRATT FNP

Nurse Practitioner (Family)