MID-MICHIGAN DERMATOLOGY, PLLC (NPI# 1093899510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093899510 |
| Entity Type | Organization |
| Organization Name | MID-MICHIGAN DERMATOLOGY, PLLC |
| Practice Address |
416 S Creyts Rd Lansing MI 48917-8290 |
| Practice Telephone | 5178860333 |
| Mailing Telephone | 5178860333 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-04-07 |
| Authorized Official Name | DR. MARK E HATCH (PRESIDENT) |
| Authorized Official Telephone | 5178860333 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | CN8644 | 01 |
| Street Address |
416 S CREYTS RD |
| City | LANSING |
| State | MI |
| Zip Code | 48917-8290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299617 | J Charles Elliott | Physician Assistant | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2005-07-14 |
| 1760938302 | Cameron Freund | Physical Therapist | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2016-09-01 |
| 1265879837 | Laura Marie Parent | Physical Therapist | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2013-05-23 |
| 1841222775 | Ronald C Miller | Dermatology | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2006-07-07 |
| 1710910641 | Sherren M White | Physician Assistant | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2006-07-07 |
| 1447289285 | Mark E Hatch | Dermatology | 416 S Creyts Rd, Lansing, MI 48917-8290 | 2006-07-02 |
| 1275570186 | Exclusive Physical Therapy Inc | Physical Therapist | 416 S Creyts Rd, Suite B, Lansing, MI 48917-8290 | 2006-05-31 |
| 1285635482 | Scott Benjamin | Physical Therapist | 416 S Creyts Rd, Suite B, Lansing, MI 48917-8290 | 2005-08-10 |
| 1184625576 | John Kolar | Physical Therapist | 416 S Creyts Rd, Suite B, Lansing, MI 48917-8290 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053937102 | Tawni Klein | Speech-Language Pathologist | 701 Snow Rd Suite A, Lansing, MI 48917 | 2020-06-24 |
| 1639700545 | Steevens Pierre Mirville | Technician | 5814 Cabrena Drive, Lansing, MI 48917 | 2020-01-29 |
| 1376197830 | Cheryl Ann Day | Physical Therapist | 7107 Treasure Isle, Lansing, MI 48917 | 2019-08-01 |
| 1912423849 | National Seating & Mobility, Inc | Durable Medical Equipment & Medical Supplies | 419 Lentz Ct, Lansing, MI 48917 | 2017-08-22 |
| 1215367149 | Thomas Ball | Pharmacist | 5125 W Saginaw, Lansing, MI 48917 | 2013-11-13 |
| 1144658659 | Eaton Care Center, LLC | Skilled Nursing Facility | 12200 Broadbent, Lansing, MI 48917 | 2013-10-18 |
| 1154768596 | Casey Stokes | Physical Therapist | 4911 W St Joe Hwy Suite 101, Lansing, MI 48917 | 2013-05-24 |
| 1164774659 | Bona Birki Gada | Pharmacist | 2410 W. Willow St, Apt A203, Lansing, MI 48917 | 2012-10-08 |
| 1497037584 | Fms Lansing, LLC | Clinic/Center | 916 Mall Drive East, Suite 100, Lansing, MI 48917 | 2011-09-14 |
| 1326332396 | Talitha P Easterly | Psychologist | 302 South Waverly, Suite 1, Lansing, MI 48917 | 2011-06-07 |
| Find all providers in zip 48917 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396822540 | Errikos Constant | Dermatology | 1515 Lake Lansing Rd, Suite A, Lansing, MI 48912-3753 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508366279 | United Dermatology Associates Pllc | Dermatology | 6500 Schaefer Rd Ste B, Dearborn, MI 48126-1813 | 2018-02-19 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1538528633 | Forefront Dermatology, S.c. | Dermatology | 1761 W M 43 Hwy Ste 2, Hastings, MI 49058 | 2016-02-17 |
| 1144554247 | Soft Medical, PC | Dermatology | 4455 Wilson Ave Sw, Grandville, MI 49418-2366 | 2009-09-23 |
| 1942468616 | A Z Dermatology PC | Dermatology | 25225 Greenfield, Southfield, MI 48075 | 2008-05-29 |
| 1043350531 | Michael J Redmond | Dermatology | 16826 Newburgh Rd, Livonia, MI 48154-1600 | 2007-02-07 |
| 1982766465 | James Joseph Simons | Dermatology | 999 6th St, Traverse City, MI 49684-2301 | 2006-12-14 |
| 1023033255 | Raymond J Dean | Dermatology | 3643 W Front St Ste A, Traverse City, MI 49684-7760 | 2006-07-12 |
| 1376083436 | Forefront Dermatology, S.c. | Dermatology | 42452 Hayes Rd, Suite 3, Clinton Township, MI 48038 | 2017-03-08 |
| 1487063392 | Forefront Dermatology, S.c. | Dermatology | 1000 E Paris Ave Se, Suite 214, Grand Rapids, MI 49546 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.