Organization
THE SKIN CANCER CENTER OF SE MICHIGAN PC
Active
Organization
THE SKIN CANCER CENTER OF SE MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. STIFF MD (OWNER/PRESIDENT)
(248) 355-5047
Entity
Organization
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
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
08/31/2007
Last updated
09/17/2014
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