Organization
NOVICE AESTHETICS AND DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED MARK NOVICE MD (OWNER)
(248) 932-3376
Entity
Organization
Contact information
Practice address
4120 W MAPLE RD STE 206, BLOOMFIELD HILLS, MI 48301-3068
(248) 932-3376
(248) 932-1046
Mailing address
7456 PADDLE WHEEL CT, BLOOMFIELD HILLS, MI 48301-3700
(248) 932-3376
(248) 932-1046
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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