THE SKIN CANCER AND DERMATOLOGY CENTER PLC (NPI# 1346732880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346732880 |
| Entity Type | Organization |
| Organization Name | THE SKIN CANCER AND DERMATOLOGY CENTER PLC |
| Practice Address |
1225 W Front St Ste 2 Traverse City MI 49684 |
| Mailing Address |
1724 Wayne St Traverse City MI 49684-1476 |
| Practice Telephone | 2314860230 |
| Mailing Telephone | 2316328456 |
| Mailing Fax Number | 2315252062 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-06-18 |
| Authorized Official Name | DR. LAUREL LEITHAUSER (OWNER AND MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2316328456 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
4301104387 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1724 Wayne St, Traverse City, MI 496841476 | 2316328456 | 2315252062 |
| Street Address |
1225 W FRONT ST STE 2 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| 1972059830 | Joy Counseling Inc | Community/Behavioral Health | 13561 S W Bay Shore Drive Suite 315, Traverse City, MI 49684 | 2016-08-31 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912132945 | Laurel Aeriel Leithauser | Dermatology | 3643 W Front St Ste A, Traverse City, MI 49684-7760 | 2009-05-19 |
| 1346457488 | Northwestern Michigan Dermatology | Dermatology | 550 Munson Ave, Suite 200, Traverse City, MI 49686-3580 | 2007-05-17 |
| 1962511097 | Mark R. Pomaranski | Dermatology | 550 Munson Ave, Suite 200, Traverse City, MI 49686 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407309560 | St Joseph Dermatology and Vein Clinic Pllc | Dermatology | 2500 Niles Rd Ste 10a, Saint Joseph, MI 49085-3272 | 2016-07-25 |
| 1003290750 | El Tal Md PC | Dermatology | 555 Midtowne St Ne Ste 301, Grand Rapids, MI 49503-5729 | 2015-07-13 |
| 1912347923 | Forefront Dermatology, S.c. | Dermatology | 4362 Cascade Road, Suite 206, Grand Rapids, MI 49546 | 2013-07-05 |
| 1699003699 | Robert G Lee P C | Dermatology | 200 S Wenona St Ste G96, Bay City, MI 48706-8831 | 2009-12-02 |
| 1265645535 | Academic Dermatology & Cosmetic Surgery Center, Pllc | Dermatology | 50182 Schoenherr Road, Shelby Twp., MI 48315 | 2007-05-07 |
| 1649300880 | Skin Care Physicians PC | Dermatology | 2026 N Beech Daly Rd, Dearborn Heights, MI 48127-3405 | 2007-03-06 |
| 1437133097 | Kent Jerome Krach | Dermatology | 43900 Garfield Road, Suite 100, Clinton Township, MI 48038 | 2005-12-06 |
| 1134124217 | Montgomery O Gillard | Dermatology | 4990 W Clark Rd, Building A, Suite 200, Ypsilanti, MI 48197-1149 | 2005-06-16 |
| 1366906364 | Tru North Dermatology | Dermatology | 315 Oakgrove St, Manistee, MI 49660-1176 | 2019-01-24 |
| 1417442898 | Concierge Dermatology & Skin Surgery Center | Dermatology | 500 Campus Dr, Hancock, MI 49930 | 2018-06-27 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on THE SKIN CANCER AND DERMATOLOGY CENTER PLC.
| 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.