Organization
ANN ARBOR DERMATOLOGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT CRAIG CATTELL III M.D. (PRESIDENT)
(734) 996-8757
Entity
Organization
Contact information
Practice address
706 W HURON ST, ANN ARBOR, MI 48103-4212
(734) 996-8757
(734) 996-8767
Mailing address
706 W HURON ST, ANN ARBOR, MI 48103-4212
(734) 996-8757
(734) 996-8767
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301036627
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H11070
BLUE CROSS BLUE SHIELD #
MI
05
—
1422078-10
—
MI
01
—
DF9791
PALMETTO GBA
—
Enumeration date
05/03/2007
Last updated
05/12/2008
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