Lake Area Dermatology PA
NPI 1710270921ActiveOrganization· Dermatology· Vadnais Heights, MN
Dermatology in Vadnais Heights, Minnesota, registered in NPPES in May 2011. The authorized official on file is Tracy Fuchs Gannon, M.D., President / Owner.
Overview
| NPI | 1710270921 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 20, 2011 |
| Last updated in NPPES | Jun 3, 2011 |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dermatology providers in Vadnais Heights
- 1023208295
- 1033435276
- 1720053937