Provider Demographics
NPI:1124078902
Name:HARTMAN, COREY LOUIS (MD)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:LOUIS
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DCLH, INC DBA/SKIN WELLNESS DERMATOLOGY
Mailing Address - Street 2:3415 INDEPENDENCE DRIVE, SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-871-7332
Mailing Address - Fax:205-871-7336
Practice Address - Street 1:3415 INDEPENDENCE DRIVE, SUITE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-871-7332
Practice Address - Fax:205-871-7336
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25680207N00000X
ALMD25680207NS0135X
ALM.D.25680207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology