| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Dermatology |
| DEFINITION | A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
| AREA OF SPECIALIZATION | Pediatric Dermatology |
| STATUS | Active |
| VA CODE | V180505 |
| X12 CODE | 207NP0225X |
| SPECIALTY CODE | 07 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251571 |
| EFFECTIVE DATE/TIME |
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