ADVANCED DERMATOLOGY OF MICHIGAN PC (NPI# 1851708929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851708929 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY OF MICHIGAN PC |
| Practice Address |
1500 Eureka Rd Wyandotte MI 48192-6103 |
| Mailing Address |
151 Southhall Ln Suite 300 Maitland FL 32751-7176 |
| Practice Telephone | 7342822500 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | MATT LEAVITT (OWNER) |
| Authorized Official Telephone | 4078752080 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
1500 EUREKA RD |
| City | WYANDOTTE |
| State | MI |
| Zip Code | 48192-6103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366413411 | Jan Prusinowski | Physician Assistant | 1500 Eureka Rd, Wyandotte, MI 48192-6103 | 2006-01-27 |
| 1659745453 | Jacqueline Pawlaczyk | Nurse Practitioner | 1500 Eureka Rd, Wyandotte, MI 48192-6103 | 2015-11-17 |
| 1922436229 | Adam Charles Schmid | Nurse Practitioner | 1500 Eureka Rd, Wyandotte, MI 48192-6103 | 2013-10-23 |
| 1508074212 | Michael W. Whitworth Do PC | Dermatology | 1500 Eureka Rd, Wyandotte, MI 48192-6103 | 2007-05-18 |
| 1184749517 | Michael Wesley Whitworth | Dermatology | 1500 Eureka Rd, Wyandotte, MI 48192-6103 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1598226029 | Alicia Paulette Flores | Emergency Medicine | Henry Ford Wyandotte Hosptial, Medical Education, 2333 Biddle Ave, Wyandotte, MI 48192 | 2019-03-27 |
| 1912483819 | Fast Care Pharmacy LLC | Pharmacy | 1209 Fort St, Wyandotte, MI 48192 | 2018-07-13 |
| 1518464106 | Tyson Reed Mckechnie | Emergency Medicine | Henry Ford Wyandotte Hospital, Medical Education Dept., 2333 Biddle Ave., Wyandotte, MI 48192 | 2018-04-10 |
| 1275038572 | Joanna Fourtounis | Emergency Medicine | Henry Ford Wyandotte Medical Education Office, 2333 Biddle Ave, Wyandotte, MI 48192 | 2018-03-28 |
| 1841794120 | Henry Tan | Student in an Organized Health Care Education/Training Program | Henry Ford Wyandotte Hospital, Medical Education Depart, 2333 Biddle Ave, Wyandotte, MI 48192 | 2018-03-21 |
| 1174042857 | Ashley Marie Kobylasz | Social Worker | 1506 16th Street, Wyandotte, MI 48192 | 2017-09-14 |
| 1831630631 | Vanessa Majeski | Surgery | 8333 Biddle Ave, Henry Ford Wyandotte Hospital, Wyandotte, MI 48192 | 2017-03-13 |
| 1346796984 | Jordan Yagiela | Community/Behavioral Health | 1940 Ludington Street, Wyandotte, MI 48192 | 2016-09-01 |
| 1649642505 | Superior Visions Inc | In Home Supportive Care | 2709 Fort Street, Wyandotte, MI 48192 | 2015-10-30 |
| Find all providers in zip 48192 | ||||
| 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 |
|---|---|---|---|---|
| 1497983696 | Anthony S Kasiborski Md PC | Dermatology | 2300 Oak St, Wyandotte, MI 48192-5320 | 2009-06-25 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.