Provider Demographics
NPI:1972095974
Name:VERUM CUTIS DERMATOLOGY PLLC
Entity type:Organization
Organization Name:VERUM CUTIS DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRELSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:518-669-1830
Mailing Address - Street 1:44110 ASHBURN SHOPPING PLZ UNIT 237
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7912
Mailing Address - Country:US
Mailing Address - Phone:703-687-3105
Mailing Address - Fax:571-291-2338
Practice Address - Street 1:19500 SANDRIDGE WAY STE 320
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3695
Practice Address - Country:US
Practice Address - Phone:703-687-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty