Individual
MARK ALLYN STIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26400 W 12 MILE RD, SUITE 180, SOUTHFIELD, MI 48034-1700
(248) 355-5047
(248) 355-3511
Mailing address
26400 W 12 MILE RD, SUITE 180, SOUTHFIELD, MI 48034-1700
(248) 355-5047
(248) 355-3511
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4301052816
MI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
4301052816
MI
207ND0900X
Dermatopathology Physician
4301052816
MI
207NS0135X
Procedural Dermatology Physician
4301052816
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3341836
—
MI
Enumeration date
05/31/2006
Last updated
09/17/2014
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