SILVERTON SKIN INSTITUTE PLLC (NPI# 1417090317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417090317 |
| Entity Type | Organization |
| Organization Name | SILVERTON SKIN INSTITUTE PLLC |
| Practice Address |
8245 Holly Rd Suite 101 Grand Blanc MI 48439-2443 |
| Mailing Address |
3495 S Center Rd Burton MI 48519-1455 |
| Practice Telephone | 8106067500 |
| Practice Fax Number | 8106069600 |
| Mailing Telephone | 8104242007 |
| Mailing Fax Number | 8107431099 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-09-20 |
| Authorized Official Name | KIMBALL SILVERTON (OWNER) |
| Authorized Official Telephone | 8104242007 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 5101009273 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
8245 HOLLY RD SUITE 101 |
| City | GRAND BLANC |
| State | MI |
| Zip Code | 48439-2443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568498772 | Christopher David Tykocki | Obstetrics & Gynecology | 8245 Holly Rd, Suite 103, Grand Blanc, MI 48439-2443 | 2006-06-23 |
| 1730320664 | Elizabeth Nickerson | Occupational Therapist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2009-03-24 |
| 1104067206 | Jennifer Christine Edwards-mayes | Speech-Language Pathologist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439 | 2009-03-19 |
| 1073754248 | Gail Henig | Speech-Language Pathologist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2009-03-17 |
| 1780841502 | Linda M Garrison | Speech-Language Pathologist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-20 |
| 1265699292 | Sheryl L Carpenter | Occupational Therapist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-19 |
| 1083871008 | Marie M Emert | Physical Therapist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-19 |
| 1952568990 | Charlene M Combs | Occupational Therapist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-19 |
| 1528225430 | Kami E Martinez | Speech-Language Pathologist | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-19 |
| 1922265842 | Lisa K Briggs | Physical Therapy Assistant | 8245 Holly Rd, Suite 204, Grand Blanc, MI 48439-2443 | 2008-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598931 | Fady Essi | Pharmacist | 6160 S Saginaw Road, Grand Blanc, 48439, USA 48439 | 2020-11-04 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1457975476 | Lauren Nicole Holmes | Obstetrics & Gynecology | Gme Department, 1 Genesys Pkwy, Grand Blanc, MI 48439 | 2020-06-05 |
| 1366063927 | Hadeel Ghazi Barrawi | Family Medicine | Ascension Genesys Hospital, Office of Medical Education, One Genesys Parkway, Grand Blanc, MI 48439 | 2020-05-05 |
| 1245851427 | Adriana Sharp | Surgery | 1 Genesys, Grand Blanc, MI 48439 | 2020-04-29 |
| 1114485109 | Kristen Milefchik | Case Manager/Care Coordinator | 278 Fox Chase Blvd, Grand Blanc, MI 48439 | 2019-03-08 |
| 1588134175 | Audrie Brook Mullin | Registered Nurse | 2313 E. Hill Rd, Grand Blanc, MI 48439 | 2018-11-27 |
| 1457845703 | Michael Patrick Tuczynski | Family Medicine | One Genesys Parkway Ascension Genesys Hospital, Attn: Debra Shuck, Grand Blanc, MI 48439 | 2018-06-20 |
| 1104318112 | Wellbridge At Genesys Health Park, LLC | Skilled Nursing Facility | 3139 East Baldwin Road, Grand Blanc, MI 48439 | 2018-06-05 |
| 1336648393 | Raedeane Kenway | Dental Hygienist | 8542 Holly Rd, Grand Blanc, MI 48439 | 2018-02-06 |
| Find all providers in zip 48439 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225410756 | Kelsey Louise Lawrence | Dermatology | 849 Health Park Blvd, Grand Blanc, MI 48439-7383 | 2015-06-20 |
| 1336212216 | John Robert Love | Dermatology | 1403 Kings Carriage Rd, Grand Blanc, MI 48439-8787 | 2006-11-16 |
| 1700429685 | Greater Michigan Dermatology, Pllc | Dermatology | 849 Health Park Blvd, Grand Blanc, MI 48439-7383 | 2019-10-23 |
| 1902288806 | Matthew Lewis Clark | Dermatology | 8245 Holly Rd Ste 101, Grand Blanc, MI 48439-2443 | 2015-06-26 |
| 1013924570 | Kimball W Silverton | Dermatology | 8245 Holly Rd, Grand Blanc, MI 48439-2443 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595616 | Diamond Dermatology, Pllc. | Dermatology | 3206 N Main St, Royal Oak, MI 48073-3424 | 2020-07-16 |
| 1477179174 | Alicia Scopis | Dermatology | 50505 Schoenherr Rd Ste 325, Shelby Township, MI 48315-3142 | 2020-06-18 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
| 1245744242 | Maureen Cliffel Do Pllc | Dermatology | 26454 Woodward Ave Ste 200, Royal Oak, MI 48067-0969 | 2017-11-29 |
| 1306375365 | Lindsay Christina El Awadi | Dermatology | 50182 Schoenherr Rd, Shelby Twp, MI 48315-3136 | 2017-06-05 |
| 1396278099 | Sasank Konda | Dermatology | 3031 W. Grand Blvd., 8th Floor, Dept. of Dermatology, Detroit, MI 48202 | 2017-04-10 |
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1679955041 | Luke D Killpack | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2015-06-22 |
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| City | GRAND BLANC |
| Zip Code | 48439 |
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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.