Organization
GREATER MICHIGAN DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELSEY LAWRENCE MD (OWNER)
(810) 498-4354
Entity
Organization
Contact information
Practice address
849 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(810) 498-4354
(810) 498-4355
Mailing address
849 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(415) 802-1310
(810) 498-4355
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225410756
NPI
MI
Enumeration date
10/23/2019
Last updated
05/24/2021
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