Midwest Center for Dermatology & Pathology, PLLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

MIDWEST CENTER FOR DERMATOLOGY & PATHOLOGY, PLLC

Practice address

43900 Garfield Rd
Suite 100
Clinton Township, MI 48038-1128

Phone

(586) 286-0112

Fax

(586) 286-2702

NPI assigned

Oct 26, 2007

Last updated

Oct 26, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Altman, M.D.NPI 1205831005

Title

Director

Phone

(586) 574-2800

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David A Altman, MD

  • Dermatology Physician
  • Warren, MI
  • NPI 1205831005
  Medicare reassignment Care Compare group NPD Authorized official
• Taylor Adlam, MD

  • Dermatology Physician
  • Dearborn, MI
  • NPI 1003473851
  Medicare reassignment Care Compare group NPD
• Aaron Stuart Cetner, M.D.

  • MOHS-Micrographic Surgery Physician
  • West Bloomfield, MI
  • NPI 1982802245
  Medicare reassignment Care Compare group NPD
• Leonard M Cetner, M.D.

  • Dermatology Physician
  • West Bloomfield, MI
  • NPI 1477667590
  Medicare reassignment Care Compare group NPD
• Tiffany Cukrowski, DO

  • Dermatology Physician
  • Clinton Township, MI
  • NPI 1255336236
  Medicare reassignment Care Compare group NPD
• Helen Maria D'Sa, D.O,

  • Dermatology Physician
  • Sterling Heights, MI
  • NPI 1346374618
  Medicare reassignment Care Compare group NPD
• Michelle Dawson, M.D.

  • Dermatology Physician
  • Clarkston, MI
  • NPI 1780027961

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michael A Dorman, MD

  • Dermatology Physician
  • West Bloomfield, MI
  • NPI 1841281532
  Medicare reassignment Care Compare group NPD
• Stuart R Gildenberg, MD

  • Dermatology Physician
  • Warren, MI
  • NPI 1194720276
  Medicare reassignment Care Compare group NPD
• Narendra Devisinh Gohel, MD

  • Surgery Physician
  • Warren, MI
  • NPI 1760439459
  Medicare reassignment Care Compare group NPD
• Leonard Yale Kerwin, M.D.

  • Dermatology Physician
  • West Bloomfield, MI
  • NPI 1942525837
  Medicare reassignment Care Compare group NPD
• Ronald David Kerwin, MD

  • Dermatology Physician
  • West Bloomfield, MI
  • NPI 1265497622
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1003095084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381128",
            "telephone_number": "586-286-0112",
            "fax_number": "586-286-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381128",
            "telephone_number": "586-286-0112",
            "fax_number": "586-286-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST CENTER FOR DERMATOLOGY & PATHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-574-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Mikho, FNP-BC
• Alisha Mikkelson
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• Jeannie Catherine Mildner, OTRL

• Dermatopathology Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Dermatopathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.