# MICHIGAN CENTER FOR DERMATOLOGY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053527226
- **Authorized official:** MR. THOMAS P. WALDINGER M.D. (PHYSICIAN)
- **Authorized official phone:** (313) 274-5810

## Contact information

- **Practice address:** 835 MASON ST STE C200, DEARBORN, MI 48124-2231
- **Practice address phone:** (313) 274-5810
- **Practice address fax:** (313) 274-1499
- **Mailing address:** 835 MASON ST STE C200, DEARBORN, MI 48124-2231
- **Mailing address phone:** (313) 274-5810
- **Mailing address fax:** (313) 274-1499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301043778 | MI | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 03/17/2018