Clinical Dermatology Center, LLC
NPI 1902428709ActiveOrganization· Dermatology· Chantilly, VA
Dermatology in Chantilly, Virginia, registered in NPPES in May 2020. The authorized official on file is Mikhail A. Pavlov, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1902428709 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 14, 2020 |
| Last updated in NPPES | Jul 17, 2020 |
| Certified by provider | Jul 17, 2020 |
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 (DC) |
|---|
Other Dermatology providers in Chantilly
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