Healthcare Provider Details

I. General information

NPI: 1194142679
Provider Name (Legal Business Name): ALLISON MARIE DARLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 DEXTER-ANN ARBOR RD SUITE 110
DEXTER MI
48130-8598
US

IV. Provider business mailing address

3621 S STATE ST
ANN ARBOR MI
48108-1633
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-4054
  • Fax:
Mailing address:
  • Phone: 734-647-5299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301104788
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: