Type not stated
Screen this subjectSkin Win Dermatology
Debarred entityUnited States. Named in 2 sanctions listings.
Summary
KMAP Provider Number 30004858080001
Sanctions and listings2
- Effective
- 12 Nov 2025
Official designation
Kansas Department of Health and EnvironmentUS Kansas Medicaid Terminated Provider ListUnited States
Terminated under a separate Medicaid enrollment.
- Effective
- 12 Nov 2025
Official designation
North Dakota Health and Human ServicesUS North Dakota Medicaid Terminated Provider ListUnited States
Failure to comply with rules and regulations.
Identifiers1
| Identifier | Number |
|---|---|
| NPI number | 1992343198 |
Addresses1
1213 15th Ave W Ste 102, Williston, ND 58801
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