NPIMap

Organization Active NPI

Ann Arbor Dermatology Clinic PC

  • Specialist
  • Ann Arbor, MI
National Provider Identifier
1376765560
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301036627 Issued in MI
Legal business name
ANN ARBOR DERMATOLOGY CLINIC PC
Practice address
706 W Huron St
Ann Arbor, MI 48103-4212
Phone
(734) 996-8757
Fax
(734) 996-8767
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Albert Craig Cattell III, M.D.
Title
President
Phone
(734) 996-8757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301036627 MI Primary

Addresses

Primary practice location

706 W Huron St
Ann Arbor, MI 48103-4212

Mailing address

706 W Huron St
Ann Arbor, MI 48103-4212
Phone (734) 996-8757

Other identifiers 3

IdentifierTypeStateIssuer
0H11070OtherMIBLUE CROSS BLUE SHIELD #
1422078-10MedicaidMI
DF9791OtherPALMETTO GBA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1376765560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 W HURON ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034212",
            "telephone_number": "734-996-8757",
            "fax_number": "734-996-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 W HURON ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034212",
            "telephone_number": "734-996-8757",
            "fax_number": "734-996-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN ARBOR DERMATOLOGY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "CATTELL",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-996-8757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301036627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "0H11070",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1422078-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "DF9791",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.