Prosynergy Dermatology LLC
NPI 1205518875ActiveOrganization· Dermatology· Martinez, GA
Dermatology in Martinez, Georgia, registered in NPPES in August 2023. The authorized official on file is Stephen Melvin Squires, MD, Ceo And President. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1205518875 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 3, 2023 |
| Last updated in NPPES | Aug 3, 2023 |
| Certified by provider | Aug 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (SC) |
|---|
Other dermatologists in Martinez
- 1104212612
- 1346476199
- 1972623288