Active NPI 1114986429 Individual Practitioner Female Practitioner

Dr. Jane T Chew , MD

Dermatology • Columbia, MD

✓ Accepts Medicare Assignment

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Jane Chew, MD is a registered Dermatology practitioner in Columbia, MD. With approximately 21 years of clinical practice since graduating from Columbia University College Of Physicians And Surgeons in 2005, Dr. Chew provides healthcare services at the registered practice location at 10910 LITTLE PATUXENT PKWY STE 205.

Dr. Chew is affiliated with Forefront Dermatology Sc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

10910 Little Patuxent Pkwy Ste 205

Columbia, MD 210443092

Telephone 4107720707

Fax 4107725654

Associated Practice Facility / Clinic

🏢 Columbia Dermatology Center Facility NPI 1649230806

Medicare Profile & Education

Medical School

Columbia University College Of Physicians And Surgeons

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Columbia, MD

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs +0.2 yrs vs City Avg

City Avg: 20.8 Yrs

State Avg: 24.6 Yrs

Regional Practice Density

8 Specialists

Practicing in Columbia, MD (363 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

72.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Chew (21 Years) 21 Yrs

Columbia Specialty Average (20.8 Years) 20.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,470	279	$84.00	$7.15
99213 Established patient office or other outpatient visit, typically 15 minutes	1,325	952	$263.00	$96.66
17000 Destruction of skin growth	479	358	$303.63	$68.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	331	268	$372.00	$135.54
11102 Tangential biopsy of single skin lesion	214	192	$378.00	$105.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	179	179	$321.00	$119.22
17110 Destruction of up to 14 skin growths	117	108	$419.00	$121.14
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	75	65	$1002.00	$326.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	65	65	$474.00	$178.98
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	57	48	$1062.15	$153.51
11103 Biopsy of related skin growth, each additional growth	53	42	$205.00	$54.40
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	48	42	$318.22	$121.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	39	$147.53	$60.67
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	25	24	$258.55	$100.51
69100 Biopsy of ear	23	22	$677.59	$83.29
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	17	$936.14	$179.73
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	14	$338.11	$127.42
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	13	12	$373.92	$142.20
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$223.46	$77.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,357	294	$84.00	$7.17
99213 Established patient office or other outpatient visit, typically 15 minutes	1,202	878	$262.64	$94.79
17000 Destruction of skin growth	466	363	$303.63	$68.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	281	224	$371.49	$133.02
11102 Tangential biopsy of single skin lesion	239	214	$377.33	$104.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	222	222	$318.97	$118.58
17110 Destruction of up to 14 skin growths	121	116	$419.00	$122.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	90	90	$474.00	$175.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	88	77	$147.53	$59.32
11103 Biopsy of related skin growth, each additional growth	72	55	$205.00	$52.18
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	53	47	$1002.00	$317.76
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	48	44	$318.22	$123.97
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	40	36	$1062.15	$153.79
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	26	21	$318.22	$112.05
99202 New patient office or other outpatient visit, typically 20 minutes	20	20	$223.46	$76.70
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	18	17	$338.11	$125.70
69100 Biopsy of ear	18	17	$677.59	$89.69
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	14	14	$373.92	$126.82
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	13	13	$258.55	$101.50
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	11	$936.14	$164.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,036	761	$188.30	$98.19
17003 Destruction of precancer skin growth, 2-14 growths	1,023	223	$73.88	$7.49
17000 Destruction of skin growth	381	303	$303.33	$72.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	204	204	$289.26	$122.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	200	175	$273.20	$138.24
11102 Tangential biopsy of single skin lesion	165	154	$286.83	$111.29
17110 Destruction of up to 14 skin growths	108	96	$340.16	$125.68
11103 Biopsy of related skin growth, each additional growth	83	63	$154.71	$55.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	59	$147.53	$60.73
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	61	55	$318.22	$123.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	48	48	$351.63	$172.54
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	42	36	$318.22	$117.14
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	34	26	$854.43	$333.62
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	31	28	$258.55	$102.19
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	29	25	$1062.15	$170.86
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	16	$936.14	$215.54
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$219.43	$79.59
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	15	12	$278.44	$92.14
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	14	$373.92	$144.12
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	15	13	$377.88	$150.53
69100 Biopsy of ear	14	13	$677.59	$77.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,023	789	$223.64	$98.15
17003 Destruction of precancer skin growth, 2-14 growths	518	238	$118.64	$7.16
17000 Destruction of skin growth	391	326	$228.89	$70.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	380	310	$277.86	$139.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	217	217	$283.71	$122.00
11102 Tangential biopsy of single skin lesion	131	121	$237.12	$114.18
17110 Destruction of up to 14 skin growths	121	108	$230.16	$124.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	89	89	$315.69	$181.03
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	51	46	$285.13	$128.08
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	51	48	$499.13	$329.68
11103 Biopsy of related skin growth, each additional growth	44	40	$99.24	$58.91
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	39	34	$262.06	$117.64
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	30	29	$646.25	$171.94
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	25	22	$253.31	$92.08
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	18	16	$317.69	$100.21
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	17	14	$339.44	$123.16
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	15	$282.78	$151.06
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	14	14	$293.98	$158.44
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$621.59	$222.74
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	11	$399.64	$155.92
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$232.50	$79.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	852	696	$280.00	$116.59
99213 Established patient office or other outpatient visit, typically 15 minutes	484	373	$238.96	$81.19
17000 Destruction of skin growth	277	242	$199.96	$69.03
17003 Destruction of precancer skin growth, 2-14 growths	188	158	$188.56	$6.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	184	184	$279.73	$116.96
11102 Tangential biopsy of single skin lesion	135	130	$200.27	$109.75
99202 New patient office or other outpatient visit, typically 20 minutes	104	104	$236.88	$82.38
17110 Destruction of up to 14 skin growths	77	75	$184.16	$121.34
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	74	69	$423.00	$329.03
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	61	54	$270.00	$119.51
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	58	46	$240.00	$112.82
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	56	53	$468.00	$171.92
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	40	36	$252.00	$89.97
11103 Biopsy of related skin growth, each additional growth	39	39	$81.33	$57.48
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	33	31	$260.00	$134.32
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	21	21	$320.00	$99.68
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	20	$425.00	$197.75
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	12	$340.00	$121.74
69100 Biopsy of ear	14	12	$185.00	$88.97
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$280.00	$154.90
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	12	$360.00	$137.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	968	744	$280.00	$114.21
17000 Destruction of skin growth	413	324	$199.98	$67.39
99213 Established patient office or other outpatient visit, typically 15 minutes	411	319	$238.57	$78.88
17003 Destruction of precancer skin growth, 2-14 growths	320	247	$177.30	$5.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	211	211	$280.00	$114.06
17110 Destruction of up to 14 skin growths	103	92	$182.81	$118.88
11102 Tangential biopsy of single skin lesion	90	87	$200.00	$102.61
99202 New patient office or other outpatient visit, typically 20 minutes	90	90	$238.20	$81.06
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	80	64	$269.75	$111.64
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	74	61	$423.00	$307.80
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	73	61	$240.00	$98.95
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	37	34	$468.00	$164.05
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	37	28	$252.00	$76.44
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	34	33	$260.00	$140.22
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	27	25	$340.00	$116.47
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	21	20	$280.00	$140.48
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	20	17	$320.00	$86.20
11103 Biopsy of related skin growth, each additional growth	17	17	$68.18	$58.02
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	14	$360.00	$122.49
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	14	12	$425.00	$193.42
69100 Biopsy of ear	13	12	$185.00	$94.71
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	13	12	$442.00	$237.48
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	13	13	$479.00	$282.23
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	12	$390.00	$115.19
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$459.00	$205.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,067	805	$198.68	$110.77
17003 Destruction of precancer skin growth, 2-14 growths	1,064	225	$38.38	$5.54
17000 Destruction of skin growth	391	310	$150.90	$63.06
99213 Established patient office or other outpatient visit, typically 15 minutes	346	262	$163.22	$74.83
11100 Biopsy of single growth of skin and/or tissue	330	290	$185.58	$108.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	246	246	$189.04	$111.55
11101 Biopsy of each additional growth of skin and/or tissue	104	84	$61.59	$33.48
17110 Destruction of up to 14 skin growths	87	84	$182.00	$117.97
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	80	68	$423.00	$304.27
99202 New patient office or other outpatient visit, typically 20 minutes	77	77	$203.38	$76.84
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	44	38	$410.82	$188.37
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	32	31	$371.63	$164.51
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	20	$312.00	$128.44
69100 Biopsy of ear	19	16	$185.00	$82.96
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	19	17	$479.00	$186.66
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	14	14	$442.00	$312.24
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	13	13	$459.00	$211.81
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	12	$1000.00	$203.64
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	11	11	$458.00	$283.21
10060 Simple or single drainage of skin abscess	11	11	$204.73	$122.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,262	290	$20.24	$6.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,081	789	$148.05	$109.44
11100 Biopsy of single growth of skin and/or tissue	493	418	$150.27	$102.88
17000 Destruction of skin growth	468	381	$111.45	$64.06
99213 Established patient office or other outpatient visit, typically 15 minutes	322	262	$99.81	$72.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	269	269	$138.79	$110.15
11101 Biopsy of each additional growth of skin and/or tissue	194	139	$52.22	$33.70
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	97	83	$375.18	$298.36
17110 Destruction of up to 14 skin growths	94	71	$154.01	$103.97
99202 New patient office or other outpatient visit, typically 20 minutes	62	62	$146.25	$75.83
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	56	50	$347.62	$182.34
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	40	35	$305.13	$163.56
69100 Biopsy of ear	29	27	$164.65	$90.56
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	23	$254.05	$120.30
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	18	16	$1000.00	$196.10
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	18	18	$423.67	$261.06
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	15	$360.18	$247.86
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$308.11	$188.23
17004 Destruction of precancer skin growth, 15 or more growths	13	11	$290.49	$159.07
10060 Simple or single drainage of skin abscess	11	11	$177.29	$118.25
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	11	11	$245.55	$154.67
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	11	11	$391.84	$199.53
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	11	11	$393.18	$318.75

Medical Specialties & State Licenses

CMS Verified: 2022-04-05

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License MD D0053963

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.

Hospital & Practice Group Affiliations

Forefront Dermatology Sc

10910 Little Patuxent Pkwy, Columbia, MD 210443092

Phone: 4107720707

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Jeffrey Frattali , PA-C

Physician Assistant - Medical

NPI 1205927613

Physician Assistant (Certified)

Anna Reznikova , PA-C

Physician Assistant

NPI 1639474927

Physician Assistant (Certified)

Dr. Adekemi Harvey , MD

Dermatology

NPI 1770803504

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location September 27, 2021

Registered at 10910 LITTLE PATUXENT PKWY STE 205, COLUMBIA, MD 210443092 (Tel: 4107720707)

📍

Updated Business Mailing Address September 27, 2021

Registered at 801 YORK ST, MANITOWOC, WI 542204630 (Tel: 9206639008)

👤

Provider Name / Credentials Updated September 27, 2021

Recorded as JANE CHEW, MD

✅

NPI Profile Active November 01, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location November 01, 2007

Registered at 10910 LITTLE PATUXENT PKWY, SUITE 205, COLUMBIA, MD 210443078 (Tel: 4107720707)

📍

Updated Business Mailing Address November 01, 2007

Registered at 3759 CHATEAU RIDGE DR, ELLICOTT CITY, MD 210424815 (Tel: 4103139841)

👤

Provider Name / Credentials Updated November 01, 2007

Recorded as JANE CHEW, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 01, 2007

Dermatology (License #D0053963 in MD)

🟢

Initial NPI Registration & Enumeration March 23, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114986429

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 23, 2006

Last Update: April 05, 2022

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

801 York St

Manitowoc, WI 542204630

Phone: 9206639008

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.