| NPI | 1841252855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRIAN O'DONNELL President 989-793-6505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI DO049303) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MI DO049303) |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: MI DO049303) | |
| 207ND0900X Dermatology Dermatopathology (Licence: MI DO049303) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: MI DO049303) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2008-05-27 |