NPI 1598271645

Treasure Valley Dermatology & Skin Cancer Center, PLLC

Organisation Dermatology Physician Meridian, ID

Practice location

Address: 2535 E Fairview Ave, Meridian, ID 83642-8072
Phone: (208) 519-4333
Fax: (208) 205-9134
Mailing address: 2535 E Fairview Ave, Meridian, ID 83642

Authorised official

Name: Dustin R Portela
Title: President
Phone: (208) 351-8088

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence O-1052 (ID)

Other Dermatology providers in Idaho →

Registry record

NPI: 1598271645
Entity type: Organization
NPI issued: 26 Dec 2017
Record last updated: 8 Apr 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.