| NPI | 1275985855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L STOCKMAN President 989-341-5078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301108678) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: MI 4301108678) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301108678) | |
| 208D00000X General Practice (Licence: MI 4301108678) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2022-01-04 |