Psoriasis and Eczema Treatment Center of Western Michigan PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC

Practice address

833 Michigan St NE
Suite 102
Grand Rapids, MI 49503-3523

Phone

(616) 459-8209

Fax

(616) 459-0313

NPI assigned

Jul 26, 2005

Last updated

Mar 22, 2018By 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

Mr. Marek A Stawiski, MDNPI 1679573331

Title

Physician

Phone

(616) 459-8209

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Marek A Stawiski, MD

  • Dermatopathology Physician
  • Grand Rapids, MI
  • NPI 1679573331

  Dermatology

  NPD Authorized official
• Connie M Anderson, PA-C

  • Physician Assistant
  • Holland, MI
  • NPI 1124012919

  Dermatology

  NPD

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1396745055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "597 Baldwin St",
            "address_purpose": "LOCATION",
            "city": "Jenison",
            "state": "MI",
            "postal_code": "494287994",
            "country_code": "US",
            "telephone_number": "616-457-4251",
            "fax_number": "616-457-8410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "STAWISKI",
        "authorized_official_first_name": "MAREK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "616-459-8209",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleta Xiaotan Prysock, AUD
• Holly Przybylski
• Julia Catherine Przybylski, M.A., BCBA
• Ann Louise Przybysz, CTRS, BS, QIDP
• Shannon Przygocki
• Psychiatry Specialists of Grand Rapids, PLLC (Thrive Center for Health)
• Psychology Associates of Grand Rapids PC
• Psychology Associates of Grand Rapids PC
• Psychology Associates of Grand Rapids PC
• Psychology Solutions, LLC

• Dermatology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.