NPI 1003668328

Wall Dermatology, LLC

Organisation MOHS-Micrographic Surgery Physician St Petersburg, FL

Practice location

Address: 1700 66th St N STE 300, St Petersburg, FL 33710-5500
Phone: (727) 432-3225
Mailing address: 3000 Boca Ciega Dr N, Saint Petersburg, FL 33710-2834

Authorised official

Name: Weston Wall
Title: Physician Owner
Phone: (727) 432-3225

Registered specialties

MOHS-Micrographic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X

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Registry record

NPI: 1003668328
Entity type: Organization
NPI issued: 2 Apr 2024
Record last updated: 5 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.