HIDRADENITIS SUPPURATIVA INSTITUTE, LLC (NPI# 1346537685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346537685 |
| Entity Type | Organization |
| Organization Name | HIDRADENITIS SUPPURATIVA INSTITUTE, LLC |
| Practice Address |
26908 Detroit Rd Suite 103 Westlake OH 44145-2398 |
| Practice Telephone | 4402490274 |
| Practice Fax Number | 4408081606 |
| Mailing Telephone | 4402490274 |
| Mailing Fax Number | 4408081606 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |
| Authorized Official Name | DR. PAUL G HAZEN (PRESIDENT) |
| Authorized Official Telephone | 4402490274 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
037749 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
26908 DETROIT RD SUITE 103 |
| City | WESTLAKE |
| State | OH |
| Zip Code | 44145-2398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139767 | Michael A Adornetto | Internal Medicine | 26908 Detroit Rd, Ste 200, Westlake, OH 44145 | 2005-07-27 |
| 1063815587 | Lisa Brown | Nurse Practitioner | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2014-09-29 |
| 1518368034 | Julie Wise | Dietitian, Registered | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2014-09-16 |
| 1649689639 | Karen Moore | Nurse Practitioner | 26908 Detroit Rd, Suite 301, Westlake, OH 44145-2398 | 2014-08-05 |
| 1871904227 | Brittany Morgan Peters | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2014-05-19 |
| 1144650227 | Vanessa Duber | Nurse Practitioner | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2013-11-26 |
| 1649610114 | Muhammad Raihan Malik | Internal Medicine | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2013-06-28 |
| 1467796417 | Julie Ellen Bradford | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-11-15 |
| 1679825947 | Maxine Paulraj-charles | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-10-10 |
| 1942564802 | Mary E Klecka | Internal Medicine | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720628902 | Inherent Basic Goodness Counseling, LLC | Social Worker | 24600 Center Ridge Road Suite 130, Westlake, OH 44145 | 2020-01-15 |
| 1700425030 | The Family Dentist of Westlake Jonathan J Klineman Dds Inc | Dentist | 26600 Detroit Rd Suite 230, Westlake, OH 44145 | 2020-01-03 |
| 1033772421 | Holding Space, LLC | Social Worker | 26404 Center Ridge Rd Building A1 Ste A7, Westlake, OH 44145 | 2019-04-21 |
| 1326532508 | Integrative Pain Care LLC | Durable Medical Equipment & Medical Supplies | 25200 Center Ridge Rd, Ste 3300, Westlake, OH 44145 | 2018-06-20 |
| 1841783990 | Wendy Lynn Wheeler | Counselor | 28263 Center Ridge Rd, Westlake, OH 44145 | 2018-06-13 |
| 1326557836 | Tiffany Manrodt | Social Worker | 24500 Center Ridge Road Bldg 4, #120, Westlake, OH 44145 | 2017-09-27 |
| 1639620792 | Stacy Ryan | Speech-Language Pathologist | 3057 Holly Lane, Westlake, OH 44145 | 2016-10-24 |
| 1790238954 | Kathleen Hanigosky | Pharmacist | 27175 Center Ridge Rd., Westlake, OH 44145 | 2016-07-25 |
| 1780073155 | Prominent Healthcare, Inc. | Community/Behavioral Health | 24650 Westlake Center Ridge Road, Westlake, OH 44145 | 2015-01-22 |
| 1902225022 | Amanda Brooke Abernathy | Physical Therapist | 850 Columbia Road, Suite #110, Westlake, OH 44145 | 2014-04-16 |
| Find all providers in zip 44145 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871018325 | Beautifully Scarred,llc | Dermatology | 6924 Spring Valley Dr Ste 160, Holland, OH 43528-9482 | 2017-08-06 |
| 1992228183 | Qiana Depp | Dermatology | 6924 Spring Valley Dr # 160, Holland, OH 43528-9482 | 2017-07-20 |
| 1578682373 | Dermatology Laser Surgery Center Inc. | Dermatology | 5 Wenger Road, Englewood, OH 45322 | 2007-03-29 |
| 1619059516 | Thomas P Blodgett | Dermatology | 39 Hidden Valley Dr, Bidwell, OH 45614-9591 | 2006-10-19 |
| 1336170851 | Doreen Dupont | Dermatology | 545 Metro Place South, Suite 100, Dublin, OH 43017 | 2006-07-05 |
| 1437147030 | Martha A Hickmann | Dermatology | 3025 Governors Place Blvd, Dayton, OH 45409 | 2005-10-10 |
| 1457343527 | Dwight A Scarborough | Dermatology | 650 Shawan Falls Dr, Dublin, OH 43017-2100 | 2005-08-16 |
| 1114928041 | Kirsten Trotter Lynch | Dermatology | 3737 Park East Dr, Suite 109, Beachwood, OH 44122-4347 | 2005-08-02 |
| 1750852620 | Alexandra Rae Buehrle | Dermatology | 9485 Mentor Ave Ste 210, Mentor, OH 44060-8723 | 2018-12-17 |
| 1669859047 | Forefront Dermatology, S.c. | Dermatology | 1830 Bethel Rd, Suite C, Columbus, OH 43220 | 2015-05-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.