Provider profile · NPI 1770973612

Advanced Dermatology Of Michigan, Pc

Dermatology · Warren, MI · NPI 1770973612 · 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

Organization

Primary specialty

Dermatology

Enumerated

Jan 30, 2015

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILING151 SOUTHHALL LN STE 300Maitland, FL 32751-7176407-875-2080
LOCATION13450 E 12 MILE RD Warren, MI 48088-3671586-759-5525

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.