Provider Demographics
NPI:1790582542
Name:CERTIFIED DERM PARTNERS LLC
Entity type:Organization
Organization Name:CERTIFIED DERM PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-621-7158
Mailing Address - Street 1:1441 OCHSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8110
Mailing Address - Country:US
Mailing Address - Phone:985-363-8254
Mailing Address - Fax:985-363-8255
Practice Address - Street 1:1441 OCHSNER BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8110
Practice Address - Country:US
Practice Address - Phone:985-400-5551
Practice Address - Fax:985-400-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty