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Organization

DRS IACOBELLI & DIGREGORIO, P.C.

Active
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Organization

DRS IACOBELLI & DIGREGORIO, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THERESA M KNOBLOCK (OFFICE MANAGER)
(586) 263-7200
Entity
Organization

Contact information

Practice address
16510 19 MILE RD, CLINTON TWP, MI 48038-1106
(586) 263-7200
(586) 263-5331
Mailing address
16510 19 MILE RD, CLINTON TWP, MI 48038-1106
(586) 263-7200
(586) 263-5331

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
07/23/2006
Last updated
08/06/2007
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