| NPI | 1588019053 |
|---|---|
| Doing Business As | LEGACY DERMATOLOGY GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHELLE SUE LEGACY President 248-338-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101017676) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2020-04-30 |