Active NPI
DRS Iacobelli & Digregorio, P.C.
- Dermatology Physician
- Clinton TWP, MI
National Provider Identifier
1831110774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- DRS IACOBELLI & DIGREGORIO, P.C.
- Practice address
- 16510 19 Mile Rd
Clinton TWP, MI 48038-1106 - Phone
- (586) 263-7200
- Fax
- (586) 263-5331
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa M Knoblock
- Title
- Office Manager
- Phone
- (586) 263-7200
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| MOHS-Micrographic Surgery Physician | 207ND0101X | |||
| Dermatopathology Physician | 207ND0900X | |||
| Procedural Dermatology Physician | 207NS0135X |
Addresses
Primary practice location
16510 19 Mile Rd
Clinton TWP, MI 48038-1106
Mailing address
16510 19 Mile Rd
Clinton TWP, MI 48038-1106
Phone (586) 263-7200
National Provider Directory
National Provider DirectoryLocations
30795 23 Mile Rd
Ste 207
Chesterfield, MI 48047
Phone (586) 263-7200
16520 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-7200
198 S Main St
Mount Clemens, MI 48043
Phone (586) 466-5960
35050 23 Mile Rd
Ste B
New Baltimore, MI 48047
Phone (586) 716-9276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186358400000",
"number": "1831110774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16510 19 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480381106",
"telephone_number": "586-263-7200",
"fax_number": "586-263-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16510 19 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480381106",
"telephone_number": "586-263-7200",
"fax_number": "586-263-5331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRS IACOBELLI & DIGREGORIO, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-23",
"last_updated": "2007-08-06",
"status": "A",
"authorized_official_last_name": "KNOBLOCK",
"authorized_official_first_name": "THERESA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "586-263-7200"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
},
{
"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": false
},
{
"code": "207NS0135X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology, Procedural Dermatology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.