JESSICA M MACDOUGALL (NPI# 1700932860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700932860 |
| Entity Type | Individual |
| Full Name | JESSICA M MACDOUGALL |
| Credential | PA |
| Practice Address |
2221 Livernois Road Suite 101 Troy MI 48083 |
| Mailing Address |
11850 Davisburg Road Davisburg MI 48350 |
| Practice Telephone | 2483623500 |
| Practice Fax Number | 2483621941 |
| Mailing Telephone | 2487222550 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 5601003859 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345283 | Jessica Dale Macdougall | Student in an Organized Health Care Education/Training Program | Pediatric Education Office 230 Macnider Hall, 333 South Columbia Street, Chapel Hill, NC 27514 | 2018-05-07 |
| Street Address |
2221 LIVERNOIS ROAD SUITE 101 |
| City | TROY |
| State | MI |
| Zip Code | 48083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| 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 |
|---|---|---|---|---|
| 1831356245 | John A Brendese | Dermatology | 2402 22nd St, Troy, NY 12180 | 2008-05-22 |
| 1528236692 | Catherine Mcconnell Ogawa | Dermatology | 6949 Erin Way, Troy, MI 48098-2173 | 2008-02-12 |
| 1649316761 | Hyman Yee | Dermatology | 3803 Edgemont Dr, Troy, MI 48084-1448 | 2007-01-29 |
| 1871605394 | John A Brendese Md PC | Dermatology | 2402 22nd Street, Troy, NY 12180 | 2006-08-31 |
| 1356395719 | Michelle M Choucair | Dermatology | 3006 N County Road 25a Ste 200, Troy, OH 45373-1372 | 2006-05-20 |
| 1316910649 | Ann E Hern | Dermatology | 230 W Maple Rd, Suite 200, Troy, MI 48084-5435 | 2006-02-08 |
| 1255313979 | Ali Moiin | Dermatology | 1575 W Big Beaver Rd, Suite C12, Troy, MI 48084-3525 | 2005-11-17 |
| 1265422497 | George J Murakawa | Dermatology | 255 Kirts Blvd, Troy, MI 48084-5260 | 2005-10-27 |
| 1548250855 | Lori Marcum Fedoronko | Dermatology | 1350 Kirts Blvd, Suite 155, Troy, MI 48084-4851 | 2005-10-27 |
| 1437149259 | Mohammad Ghaemi | Dermatology | 4792 Rochester Rd, Suite B, Troy, MI 48085-4929 | 2005-10-24 |
| Find all providers in TROY | ||||
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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.