Organization
BAY AREA DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES J SIMONS (SOLE OWNER)
(231) 941-4114
Entity
Organization
Contact information
Practice address
999 SIXTH ST, TRAVERSE CITY, MI 49684-2301
(231) 941-4114
(231) 941-0878
Mailing address
999 SIXTH ST, TRAVERSE CITY, MI 49684-2301
(231) 941-4114
(231) 941-0878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301039948
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2114154
—
MI
Enumeration date
01/06/2009
Last updated
01/06/2009
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