DR. TODD VINCENT KREITZER (NPI# 1841406766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841406766 |
| Entity Type | Individual |
| Full Name | DR. TODD VINCENT KREITZER |
| Credential | D.O. |
| Practice Address |
4815 Kanawha Ave Sw South Charleston WV 25309-1207 |
| Practice Telephone | 3047684567 |
| Practice Fax Number | 3047682277 |
| Mailing Telephone | 3047684567 |
| Mailing Fax Number | 3047682277 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 58.001750 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
4815 KANAWHA AVE SW |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774315 | Michelle Leigh Endicott | Dermatology | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 | 2005-07-14 |
| 1295017473 | Jacqueline Elizabeth Moore | Physician Assistant | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 | 2011-09-14 |
| 1174604409 | South Charleston Dermatology Pllc | Dermatology | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| 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 |
|---|---|---|---|---|
| 1316946825 | Gregory T. Lagos | Dermatology | 607 Chestnut Street, South Charleston, WV 25309-1205 | 2005-07-18 |
| 1699774315 | Michelle Leigh Endicott | Dermatology | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 | 2005-07-14 |
| 1356424667 | Center for Dermatology & Skin Care, Inc. | Dermatology | 607 Chestnut Street, South Charleston, WV 25309-1205 | 2006-10-23 |
| 1174604409 | South Charleston Dermatology Pllc | Dermatology | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316350499 | Pinnacle Dermatology LLC | Dermatology | 536 N Jefferson St, Suite 200, Lewisburg, WV 24901-1164 | 2014-06-06 |
| 1255677555 | Derm One Pllc | Dermatology | 34 New Hope Rd, Suite 1, Princeton, WV 24740-2354 | 2012-12-14 |
| 1285876011 | Zachary Allen Zinn | Dermatology | 1 Stadium Dr Ste 3, Morgantown, WV 26506-7900 | 2009-03-25 |
| 1902091101 | Virginias Dermatology, Inc. | Dermatology | 1 Country Club Hl, Bluefield, WV 24701-4467 | 2007-09-11 |
| 1972797231 | Appalachian Spring Dermatology, Pllc | Dermatology | 100 Village Dr, Suite 201, Fairmont, WV 26554-7986 | 2007-08-30 |
| 1801910880 | Erik B Hurst | Dermatology | 1000 Sushruta Dr, Martinsburg, WV 25401-8876 | 2007-03-16 |
| 1356415533 | Kenneth F Hardy Jr. | Dermatology | 1311 Pineview Drive, Suite 200, Morgantown, WV 26505 | 2006-11-20 |
| 1114091287 | William Lloyd Hall | Dermatology | 400 Drummond Street, Morgantown, WV 26505-3320 | 2006-11-20 |
| 1679669345 | Allen George Saoud | Dermatology | 170 Thompson Dr Ste 200, Bridgeport, WV 26330-2608 | 2006-10-04 |
| 1588629166 | Stephen Kirby Milroy | Dermatology | 3100 Mccorkle Ave Se, Ste 809, Charleston, WV 25304-1223 | 2006-04-18 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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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.