Organization
BAY VIEW DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERRI S. VAZALES M.D. (PRESIDENT)
(231) 487-6700
Entity
Organization
Contact information
Practice address
560 W MITCHELL ST, SUITE 510, PETOSKEY, MI 49770-2275
(231) 487-6700
(231) 487-0303
Mailing address
560 W MITCHELL ST, SUITE 510, PETOSKEY, MI 49770-2275
(231) 487-6700
(231) 487-0303
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015180
RR MEDICARE
MI
Enumeration date
06/17/2006
Last updated
08/02/2010
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