Organization
ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY PC
Active
Other names
ASSOCIATES IN DERMATOLOGY OF TRAVERSE CITY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN MICHELLE GRINER MD (PRESIDENT)
(231) 935-0625
Entity
Organization
Contact information
Practice address
3643 W FRONT ST, TRAVERSE CITY, MI 49684-7759
(231) 935-0625
(231) 935-0626
Mailing address
3643 W FRONT ST, TRAVERSE CITY, MI 49684-7760
(231) 935-0625
(231) 935-0626
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
JG058054
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF3512
RAILROAD MEDICARE
MI
Enumeration date
06/03/2006
Last updated
10/25/2007
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