Organization
ADVANCED DERMATOLOGY OF MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT LEAVITT DO (OWNER)
(407) 875-2080
Entity
Organization
Contact information
Practice address
1500 EUREKA RD, WYANDOTTE, MI 48192-6103
(734) 282-2500
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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