| NPI | 1346457488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOUMIT SHAM PENDHARKAR Office Manager 231-935-8717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |