Provider Demographics
NPI:1528348521
Name:ROBERT K DYER MD DERMATOLOGY LLC
Entity type:Organization
Organization Name:ROBERT K DYER MD DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-330-9588
Mailing Address - Street 1:3461 S COUNTY TRL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1465
Mailing Address - Country:US
Mailing Address - Phone:401-471-3376
Mailing Address - Fax:401-471-6865
Practice Address - Street 1:3461 S COUNTY TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1465
Practice Address - Country:US
Practice Address - Phone:401-471-3376
Practice Address - Fax:401-471-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty