FRED MARK NOVICE (NPI# 1265517635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265517635 |
| Entity Type | Individual |
| Full Name | FRED MARK NOVICE |
| Credential | MD |
| Practice Address |
4120 West Maple Road Suite 206 Bloomfield Hills MI 48301 |
| Mailing Address |
7456 Paddlewheel Crt Bloomfield Hills MI 48301 |
| Practice Telephone | 2489323376 |
| Practice Fax Number | 2489321046 |
| Mailing Telephone | 2489323376 |
| Mailing Fax Number | 2489321046 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 4301406190 | MI | Allopathic & Osteopathic Physicians |
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
4301406190 | MI | Allopathic & Osteopathic Physicians |
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
16422 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BS | 06392341 | 01 |
| Street Address |
4120 WEST MAPLE ROAD SUITE 206 |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386278992 | Next Level Home Care | Home Health | 3595 W Maple Rd Ste 208, Bloomfield Hills, MI 48301 | 2020-02-24 |
| 1811352230 | Freda B. Lerman, Lpc, Psyd, Lp, Pllc | Psychologist | 6905 Telegraph Road Suite 100, Bloomfield Hills, MI 48301 | 2015-12-30 |
| 1790113223 | Kathy Biehl Kelly | Nurse Practitioner | 3355 Morningview Terrace, Bloomfield Hills, MI 48301 | 2013-10-18 |
| 1538406855 | Dynamic Home Health Care Agency | Case Management | 3744 Lincoln Drive, Bloomfield Hills, MI 48301 | 2013-01-07 |
| 1366798373 | A3 Medical | Family Medicine | 4050 Maple Road, Suite 101, Bloomfield Township, MI 48301 | 2012-07-27 |
| 1013299361 | Michael Kovel Samson | Internal Medicine | 4790 Apple Grove Court, Bloomfield Hills, MI 48301 | 2011-09-13 |
| 1376786152 | Pamela Ann Hibbard Timrek | Speech-Language Pathologist | 3816 Lincoln Drive, Bloomfield Township, MI 48301 | 2009-04-09 |
| 1164694584 | Alexandra Krot | Internal Medicine | 169 Bassett Place, Bloomfield Hills, MI 48301 | 2008-03-26 |
| 1619170644 | Latha T Kannan, Md, PC | Internal Medicine | 6715 Birmingham Club Drive, Bloomfield Hills, MI 48301 | 2007-06-07 |
| 1699802975 | Rebeca Urquiola | Dentist | 4220 Surrey Cross, Bloomfield Hills, MI 48301 | 2007-02-27 |
| Find all providers in zip 48301 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114489945 | Novice Aesthetics and Dermatology Pllc | Dermatology | 4120 W Maple Rd Ste 206, Bloomfield Hills, MI 48301-3068 | 2019-04-01 |
| 1841274032 | Neldagae S Chisa | Dermatology | 36700 Woodward Ave, Ste 203, Bloomfield Hills, MI 48304-0926 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962585596 | Wei Su | Dermatology | 43900 Garfield Rd Ste 100, Clinton Township, MI 48038-1137 | 2006-10-24 |
| 1629090691 | Janine Mangini | Dermatology | 16520 19 Mile Rd, Clinton Twp, MI 48038-1106 | 2006-07-25 |
| 1619909611 | Nicole M. Bossenbroek | Dermatology | 6225 Prairie St, Norton Shores, MI 49444-7831 | 2006-07-07 |
| 1104874411 | S L Husain Hamzavi | Dermatology | 43151 Dalcoma Dr, Suite 1, Clinton Twp, MI 48038-6306 | 2006-05-05 |
| 1528052834 | John Michael Pelachyk | Dermatology | 1602 Military St, Port Huron, MI 48060-5933 | 2005-09-01 |
| 1528599750 | Singer Dermatology | Dermatology | 29355 Northwestern Hwy, 302, Southfield, MI 48034-1053 | 2017-03-21 |
| 1538538178 | Specialized Pathology Partners PC | Dermatology | 4798 Wenmar Dr, Saginaw, MI 48604-2843 | 2015-09-24 |
| 1255724100 | West Michigan Pathology Specialists, PC | Dermatology | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2015-03-16 |
| 1760812523 | Scott Conley Bresler | Dermatology | 1500 E Medical Center Dr, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2013-11-14 |
| 1053547885 | Liaqat Ali | Dermatology | 1314 N Macomb St, Monroe, MI 48162-3131 | 2009-06-08 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.