Healthcare Provider Details

I. General information

NPI: 1255323341
Provider Name (Legal Business Name): BARRY I AUSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31275 NORTHWESTERN HWY STE 140
FARMINGTON HILLS MI
48334-2531
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR LBBY J2000
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 248-538-0109
  • Fax: 248-538-0675
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301039912
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: