Organization
DERMATOLOGY SPECIALISTS OF GRAND RAPIDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILTEFAT HAMZAVI (M.D.)
(810) 650-0995
Entity
Organization
Contact information
Practice address
1000 EAST PARIS AVE SE STE 104, GRAND RAPIDS, MI 49546-3680
(586) 876-2345
Mailing address
43151 DALCOMA DR STE 4, CLINTON TOWNSHIP, MI 48038-6306
(586) 876-2345
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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