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

PurposeAddressCity/StatePhone
LOCATION1740 E PARIS AVE SE Grand Rapids, MI 49546-6204616-949-5600
MAILING1740 E PARIS AVE SE Grand Rapids, MI 49546-6204616-949-5600

View on NPPES registry ↗

Watch this provider

Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.