PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC (NPI# 1396745055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396745055 |
| Entity Type | Organization |
| Organization Name | PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC |
| Practice Address |
833 Michigan St Ne Suite 102 Grand Rapids MI 49503-3523 |
| Practice Telephone | 6164598209 |
| Practice Fax Number | 6164590313 |
| Mailing Telephone | 6164598209 |
| Mailing Fax Number | 6164590313 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2018-03-22 |
| Authorized Official Name | MR. MAREK A STAWISKI (PHYSICIAN) |
| Authorized Official Telephone | 6164598209 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 597 Baldwin St, Jenison, MI 494287994 | 6164574251 | 6164578410 |
| Street Address |
833 MICHIGAN ST NE SUITE 102 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-3523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530909 | Richard Hugh Benninger | Ophthalmology | 833 Michigan St Ne, Suite 101, Grand Rapids, MI 49503-3523 | 2005-07-07 |
| 1689136434 | Beth Needham Sweney | Physician Assistant | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2019-04-02 |
| 1356844831 | Matthew T Zoeteman | Physician Assistant | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2018-03-12 |
| 1649516907 | Mary A Yurko Md Dermatology Plc | Dermatology | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2012-12-13 |
| 1619958576 | John R. Vydareny | Dermatology | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2005-11-08 |
| 1124012992 | Mary Ann Yurko | Dermatology | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2005-09-07 |
| 1679573331 | Marek A Stawiski | Dermatology | 833 Michigan St Ne, Suite 102, Grand Rapids, MI 49503-3523 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1306289574 | Nicholas Michael Bontumasi | Dermatology | 4362 Cascade Road Se, Grand Rapids, MI 49546-3631 | 2013-04-08 |
| 1821350745 | Kristi B Hawley | Dermatology | 6750 Kalamazoo Ave Se Ste C, Grand Rapids, MI 49508-7897 | 2012-06-15 |
| 1437380102 | Adam D Asarch | Dermatology | 4362 Cascade Rd Se, Suite 206, Grand Rapids, MI 49546-3600 | 2009-07-29 |
| 1588783419 | Dara Spearman | Dermatology | 4352 Cascade Road, Suite 206, Grand Rapids, MI 49546-3631 | 2007-03-29 |
| 1962595199 | Howard Alan Beadner | Dermatology | 2124 Woodcliff Ave. Se, Grand Rapids, MI 49546-5711 | 2006-10-02 |
| 1508960253 | Robert W Stokes | Dermatology | 1815 Breton Rd Se, Suite C1, Grand Rapids, MI 49506 | 2006-09-12 |
| 1649260688 | Richard J Ashack | Dermatology | 1740 E Paris Ave Se, Grand Rapids, MI 49546-6204 | 2005-10-21 |
| 1073976338 | Kurt Ashack | Dermatology | 1740 E Paris Ave Se, Grand Rapids, MI 49546-6204 | 2016-04-03 |
| 1376924902 | David Oberlin | Dermatology | 4362 Cascade Rd Se Ste 206, Grand Rapids, MI 49546 | 2015-06-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC.
| 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.