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Organization

CANTON DERMATOLOGY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUE MARK (MEDICAL BILLER)
(734) 455-4917
Entity
Organization

Contact information

Practice address
8584 N CANTON CENTER RD, CANTON, MI 48187-1310
(734) 455-4917
Mailing address
8584 N CANTON CENTER RD, CANTON, MI 48187-1310
(734) 455-4917

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DB032249
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101256
CARE CHOICES
MI
01
102494
CARE CHOICES
MI
01
2363389001
CIGNA
MI
01
3899973001
CIGNA
MI
01
4072568
AETNA
MI
01
4139614
AETNA
MI
01
64889A
HEALTH ALLIANCE PLAN
MI
01
64889B
HEALTH ALLIANCE PLAN
MI
01
B5020
MCARE
MI
01
C2791
MCARE
MI
Enumeration date
03/16/2006
Last updated
02/15/2008
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