Michigan Skin Clinics PC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

4301108678 Issued in MI

Legal business name

MICHIGAN SKIN CLINICS PC

Practice address

3925 Fortune Blvd
Saginaw, MI 48603-2287

Phone

(989) 459-2300

Fax

(989) 791-1392

NPI assigned

Jul 7, 2016

Organization subpart

No

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

Authorized official

Name

Dr. David L Stockman, MD

Title

President

Phone

(989) 341-5078

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1275985855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 FORTUNE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032287",
            "telephone_number": "989-459-2300",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 FORTUNE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032287",
            "telephone_number": "989-459-2300",
            "fax_number": "989-791-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SKIN CLINICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-341-5078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "MI",
            "license": "4301108678",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "MI",
            "license": "4301108678",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301108678",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301108678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Medical and Rehabilitaiton Supply
• Michigan Neurocare PLLC
• Michigan Orthopedic Services LLC
• Michigan Physicians Eyecare Group, P.C.
• Michigan Prostate and Urological Institute, P.C.
• Michigan Spine and Brain Institute
• Michigan Spine and Brain Institute PC
• Michigan Spine and Brain Institute PC
• Michigan Total Rehab Services, PLLC
• Michigan Urine Toxicology and Research LLC

• Dermatopathology Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Dermatopathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.