SUNRISE DERMATOLOGY LLC (NPI# 1649562521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649562521 |
| Entity Type | Organization |
| Organization Name | SUNRISE DERMATOLOGY LLC |
| Other Organization Name | SUNRISE DERMATOLOGY |
| Practice Address |
70 Midtown Park E Mobile AL 36606-4140 |
| Practice Telephone | 2512891786 |
| Mailing Telephone | 2512891786 |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2019-04-05 |
| Authorized Official Name | SARAH WIERSZALOWSKI (ADMINISTRATOR) |
| Authorized Official Telephone | 2515446407 |
| Authorized Official Credential | MSN, RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD30842 | AL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sunrise Dermatology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8832 Us Highway 90, Daphne, AL 365263652 | 2512891786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538630751 | Sunrise Dermatology LLC | Dermatology | 8832 Us Hwy 90, Daphne, AL 36526 | 2018-12-16 |
| Street Address |
70 MIDTOWN PARK E |
| City | MOBILE |
| State | AL |
| Zip Code | 36606-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851447460 | Scott Freeman | Dermatology | 70 Midtown Park E, Mobile, AL 36606-4140 | 2007-01-26 |
| 1225579485 | Sunrise Skin Cancer Surgery Center, LLC | Clinic/Center | 70 Midtown Park E, Mobile, AL 36606-4140 | 2017-03-20 |
| 1720452584 | Sunrise Dermatology | Nurse Practitioner | 70 Midtown Park E, Mobile, AL 36606-4140 | 2015-11-17 |
| 1336548866 | Melissa Kominek Williams | Nurse Practitioner | 70 Midtown Park E, Mobile, AL 36606-4140 | 2014-08-20 |
| 1538330238 | Ryan Burke Ramagosa | Dermatology | 70 Midtown Park E, Mobile, AL 36606-4140 | 2008-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982216388 | Kaitlyn Culotta Dozier | Student in an Organized Health Care Education/Training Program | 936 Grant Park Drive, Mobile, AL 36606 | 2020-08-18 |
| 1902466758 | Gulf Coast Totalcare | Case Management | 3280 Dauphin Street, Building C, Suite 1, Mobile, AL 36606 | 2019-06-14 |
| 1023581246 | Elizabeth Fair | Psychologist | 3168 Midtown Park S Ste E, Mobile, AL 36606 | 2019-01-10 |
| 1962987420 | Asra Bashir | Pharmacist | 101 East Interstate 65 Service Rd S, Mobile, AL 36606 | 2018-10-01 |
| 1902398274 | Tunisia London | Social Worker | 601 Bel Air Blvd Ste 411, Mobile, AL 36606 | 2018-06-03 |
| 1962925677 | Tasheka Janine Scott I | Nurse's Aide | 629 Crenshaw Street, Mobile, AL 36606 | 2017-07-25 |
| 1295128189 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1450 Tingle Circle West, Mobile, AL 36606 | 2015-03-17 |
| 1437441623 | Julia Marco Williams | Counselor | 605 Bel Air Blvd Ste 33, Mobile, AL 36606 | 2011-05-06 |
| 1235363516 | Jenny M Neese | Dietitian, Registered | 2504 Dauphin Street, Suite J, Mobile, AL 36606 | 2009-05-14 |
| 1609000223 | Bay Area Nutrition, Inc | Dietitian, Registered | 2029-b Airport Blvd, Suite 195, Mobile, AL 36606 | 2009-05-11 |
| Find all providers in zip 36606 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891179727 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 6701 Airport Blvd Ste D232, Mobile, AL 36608-6757 | 2015-07-09 |
| 1851447460 | Scott Freeman | Dermatology | 70 Midtown Park E, Mobile, AL 36606-4140 | 2007-01-26 |
| 1487755328 | Aldo Trovato | Dermatology | 3715 Dauphin Street Building 2, 4th Floor, Mobile, AL 36608-1771 | 2006-09-25 |
| 1477577757 | Robert Neil Capper | Dermatology | 5317 Oak Bend Ct, Mobile, AL 36609-2202 | 2006-07-27 |
| 1366471286 | John Scott Vanloock | Dermatology | 6163 Omni Park Dr, Mobile, AL 36609-5195 | 2006-07-02 |
| 1700826443 | Roberta G Swain | Dermatology | 3153 Dauphin St, Mobile, AL 36606-4061 | 2006-06-08 |
| 1912985243 | Amy M Morris | Dermatology | 4310 Old Shell Rd, D, Mobile, AL 36608-2049 | 2006-01-06 |
| 1649266792 | Thomas W Bender IIi | Dermatology | 580 Providence Park Dr E, 2nd Floor, Mobile, AL 36695-4614 | 2005-09-23 |
| 1891798807 | Belin Fred Bodie | Dermatology | 4300 Old Shell Rd, Ste B, Mobile, AL 36608-2036 | 2005-05-23 |
| 1255994141 | University of South Alabama Health Care Authority | Dermatology | 4300 Old Shell Rd Ste B, Mobile, AL 36608-2036 | 2019-04-17 |
| Find all providers in MOBILE | ||||
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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.