Mark Allyn Stiff, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

4301052816 Issued in MI

Practice address

26400 W 12 Mile Rd
Suite 180
Southfield, MI 48034-1700

Phone

(248) 355-5047

Fax

(248) 355-3511

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1154368165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD",
            "address_2": "SUITE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341700",
            "telephone_number": "248-355-5047",
            "fax_number": "248-355-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26400 W 12 MILE RD",
            "address_2": "SUITE 180",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341700",
            "telephone_number": "248-355-5047",
            "fax_number": "248-355-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIFF",
        "first_name": "MARK",
        "middle_name": "ALLYN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "4301052816",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MI",
            "license": "4301052816",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301052816",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MI",
            "license": "4301052816",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3341836",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebeca Stewart
• Robert Stewart II
• Sherry Stewart
• Sydney L Stewart
• Tamara Stewart
• Stines Dental Associates
• Alfred Vincent Stines, DDS
• Bobby Stinnette, LPC
• Richard Mark Stober, MD
• Kristina M Stock

• MOHS-Micrographic Surgery Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• MOHS-Micrographic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.