Registry details
Type
Individual
Primary specialty
Dermatology, MOHS-Micrographic Surgery
Enumerated
Jun 4, 2018
License(s)
4301509082 (MI), 4301509082 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 24924 MICHIGAN AVE | Dearborn, MI 48124-1740 | 313-663-0099 |
| LOCATION | 24924 MICHIGAN AVE | Dearborn, MI 48124-1740 | 313-631-3550 |
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