Northern Michigan Dermatology Pc

LBN: Northern Michigan Dermatology Pc
Northern Michigan Dermatology Pc is an health care organization with primary practice located at 125 N Main St , Cheboygan MI 49721-1637. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Northern Michigan Dermatology Pc can be contacted via phone (231) 627-3800, or through Gray, William Roger via phone (231) 627-3800.

Contact Information

Primary practice address
125 N Main St Cheboygan MI 49721-1637
Phone: (231) 627-3800
Fax: (231) 627-2482
Website:
Map and Directions
Authorized official contact:
Name: Gray, William Roger Doctor of Osteopathy (DO)
Phone: (231) 627-3800

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X WG008271 Michigan

Profile Details

NPI number 1801082987
LBN Legal business name Northern Michigan Dermatology Pc
DBA Doing business as
Authorized official Gray, William Roger Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2007
Last updated Oct 5th, 2010 - about 14 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 1801082987 NPPES
Other 0751600054 BCBSM
MEDICAID 3055165 BCBSM

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