Advanced Dermatology Pllc in Saint Joseph - Dermatology
Advanced Dermatology Pllc - NPI 1538192018
Advanced Dermatology Pllc is a Dermatology in Saint Joseph, Michigan. Advanced Dermatology Pllc practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Advanced Dermatology Pllc is 1538192018. The last update date is 2010-03-25.
Advanced Dermatology Pllc's current location address is 300 E Maiden Ln, Saint Joseph, Michigan. You can contact this provider via phone number 2694297546 and fax number 2694290807. The mailing address for Advanced Dermatology Pllc is 300 E Maiden Ln, Saint Joseph, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Advanced Dermatology Pllc |
|---|---|
| Address | 300 E Maiden Ln, Saint Joseph, Michigan |
| Phone Number | 2694297546 |
| Fax Number | 2694290807 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PROV |
|---|---|
| Authorized Official Name | Kutriata A Mark |
| Credentials | D.O. |
| Telephone Number | 2694297546 |
NPI Number Detail
| NPI Number | 1538192018 |
|---|---|
| Provider Enumeration Date | 2006-07-08 |
| Last Updated Date | 2010-03-25 |
Provider Mailing Address Detail
| Address | 300 E Maiden Ln |
|---|---|
| City | Saint Joseph |
| State | Michigan (MI) |
| Post Code | 490858516 |
| Phone Number | 2694297546 |
| Fax Number | 2694290807 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 5101012454 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 751100205 | BLUE CROSS | ||
| CG9582 | MI | PALMETTO GBA GROUP | |
| 350460011 | MI | -- | |
| 0A10115 | MI | BCBSM GROUP |
Post Comment/ Review Below
What is the unique provider identifier assigned to Advanced Dermatology Pllc?
The Advanced Dermatology Pllc has been issued the NPI (National Provider Identifier) 1538192018 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Advanced Dermatology Pllc's physical address?
The Advanced Dermatology Pllc is physically located at 300 E Maiden Ln, in the city of Saint Joseph, MI, with the postal code 490858516.
What is Advanced Dermatology Pllc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Advanced Dermatology Pllc's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1538192018 to Advanced Dermatology Pllc?
The Centers for Medicare & Medicaid Services originally issued the 1538192018 to Advanced Dermatology Pllc on 2006-07-08.
When was the information pertaining to Advanced Dermatology Pllc most recently updated or revised?
The details related to Advanced Dermatology Pllc, including its address, specialty, and other relevant information, were last updated or revised on 2010-03-25.