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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