Derm Haven Inc
NPI 1164164141ActiveOrganization· Dermatology· St George, UT
Dermatology in St George, Utah, registered in NPPES in April 2022. The authorized official on file is Tina Moussally, PA-C, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164164141 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 11, 2022 |
| Last updated in NPPES | May 19, 2022 |
| Certified by provider | May 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
Other Dermatology providers in St George
- 1841435021
- 1194561670
- 1356478101
- 1417467986
- 1164690467
- 1598261869
- 1174693733
- 1750767638
- 1093919912
- 1518169572
- 1508832726
- 1689069312