Bloomington Dermatology Clinic

LBN: Bloomington Dermatology Clinic
Bloomington Dermatology Clinic is an health care organization with primary practice located at 2001 E 3Rd St , Bloomington IN 47401-7890. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Bloomington Dermatology Clinic can be contacted via phone (812) 333-0398, or through Wilhelmus, Scott M via phone (812) 333-0398.

Contact Information

Primary practice address
2001 E 3Rd St Bloomington IN 47401-7890
Phone: (812) 333-0398
Fax: (812) 333-0698
Website:
Map and Directions
Authorized official contact:
Name: Wilhelmus, Scott M Doctor of Medicine (MD)
Phone: (812) 333-0398

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01042083A Indiana

Profile Details

NPI number 1003914920
LBN Legal business name Bloomington Dermatology Clinic
DBA Doing business as
Authorized official Wilhelmus, Scott M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2006
Last updated May 21st, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003914920 NPPES
Indiana Other 000000090314 ANTHEM
Indiana Other $$$$$$$$$ ANTHEM

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