Provider profile · NPI 1154732386
Eileen Larkin Axibal, M.D.
Dermatology, MOHS-Micrographic Surgery · Grand Rapids, MI · NPI 1154732386 · No federal exclusion match
✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.
Registry details
Type
Individual
Primary specialty
Dermatology, MOHS-Micrographic Surgery
Enumerated
May 9, 2014
License(s)
2019-00214 (NC), 82323 (SC), 021728 (CO), 4301502472 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1740 E PARIS AVE SE | Grand Rapids, MI 49546-6204 | 616-949-5600 |
| MAILING | 1740 E PARIS AVE SE | Grand Rapids, MI 49546-6204 | 616-949-5600 |
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