Provider Demographics
NPI:1548874449
Name:CLEARVIEW DERMATOLOGY PLLC
Entity type:Organization
Organization Name:CLEARVIEW DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:OVERMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:415-802-1310
Mailing Address - Street 1:14789 W 87TH PKWY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-1338
Mailing Address - Country:US
Mailing Address - Phone:415-802-1310
Mailing Address - Fax:
Practice Address - Street 1:14789 W 87TH PKWY
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-1338
Practice Address - Country:US
Practice Address - Phone:720-797-9184
Practice Address - Fax:720-797-9186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty