Organization
KALAMAZOO DERMATOLOGY, P.C.
Active
Organization
KALAMAZOO DERMATOLOGY, P.C.
Active
Other names
KALAMAZOO DERMATOLOGY & SKIN CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
LORI KOLLIN (PRACTICE MANAGER)
(269) 343-4679
Entity
Organization
Contact information
Practice address
6100 NEWPORT RD, STE 100, PORTAGE, MI 49002-9235
(269) 343-4679
(269) 343-5929
Mailing address
6100 NEWPORT RD, STE 100, PORTAGE, MI 49002-9235
(269) 343-4679
(269) 343-5929
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA7827
PTAN
MI
Enumeration date
10/03/2006
Last updated
01/29/2015
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