Dermatology Associates, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

13703 Issued in AZ

Legal business name

DERMATOLOGY ASSOCIATES, P.C.

Practice address

3201 W Peoria Ave
Suite C-600
Phoenix, AZ 85029-4608

Phone

(602) 866-3344

Fax

(602) 375-2088

NPI assigned

Jun 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evan G Bauer, M.D.

Title

President

Phone

(602) 866-3344

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407058324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "SUITE C-600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294608",
            "telephone_number": "602-866-3344",
            "fax_number": "602-375-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "SUITE C-600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294608",
            "telephone_number": "602-866-3344",
            "fax_number": "602-375-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-866-3344",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "13703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0051960",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1700868833",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "121777",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Silvia Dergal
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• Emily Rae Derks, OTR/L
• Brenna J. Derksen, MD
• Dermal Wellness Group LLC
• Dermatology Clinic LTD
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• Darrell James Dern, M.S., CCC-SLP
• Brad Deroma
• Parker Constantine Deroo

• Dermatology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.