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Organization

DIRECT DERMATOLOGY & AESTHETICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FARHAAD RIYAZ MD (DERMATOLOGIST)
(703) 615-6569
Entity
Organization

Contact information

Practice address
48766 STONERIDGE DR, NORTHVILLE, MI 48168-8675
(703) 615-6569
Mailing address
48766 STONERIDGE DR, NORTHVILLE, MI 48168-8675
(703) 615-6569

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
02/10/2023
Last updated
02/10/2023
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