Organization
BASE DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN SOFEN MD (OWNER)
(248) 563-2489
Entity
Organization
Contact information
Practice address
27776 WOODWARD AVE, ROYAL OAK, MI 48067-0930
(248) 355-5047
(248) 355-3511
Mailing address
25504 SHERWOOD DR, HUNTINGTON WOODS, MI 48070-1752
(248) 563-2489
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043452139
PERSONAL NPI
MI
Enumeration date
12/04/2023
Last updated
07/01/2025
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