Organization
A COMPREHENSIVE DERMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI MOIIN M.D. (PHYSICIAN)
(248) 643-7677
Entity
Organization
Contact information
Practice address
1575 W BIG BEAVER RD, STE C12, TROY, MI 48084-3536
(248) 643-7677
(248) 643-7679
Mailing address
1575 W BIG BEAVER RD, STE C12, TROY, MI 48084-3536
(248) 643-7677
(248) 643-7679
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AM059655
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4251045-10
—
MI
Enumeration date
06/15/2009
Last updated
11/06/2014
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