Eastside Dermatology Pc

LBN: Lisa A Manz Dulac Md & Associates Pc
Eastside Dermatology Pc is an health care organization with primary practice located at 20030 Mack Ave , Grosse Pointe Woods MI 48236-2323. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Lisa A Manz Dulac Md & Associates Pc can be contacted via phone (313) 884-3380, or through Manz-Dulac, Lisa A via phone (313) 884-3380.

Contact Information

Primary practice address
20030 Mack Ave Grosse Pointe Woods MI 48236-2323
Phone: (313) 884-3380
Fax: (313) 884-9756
Website:
Map and Directions
Authorized official contact:
Name: Manz-Dulac, Lisa A Doctor of Medicine (MD)
Phone: (313) 884-3380

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1326007956
LBN Legal business name Lisa A Manz Dulac Md & Associates Pc
DBA Doing business as Eastside Dermatology Pc
Authorized official Manz-Dulac, Lisa A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 22nd, 2006
Last updated Jan 3rd, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326007956 NPPES
Michigan Other 23D0916007 CLIA NUMBER
Michigan Other 070H24887 CLIA NUMBER

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