Healthcare Provider Details

I. General information

NPI: 1811605660
Provider Name (Legal Business Name): DERMATOLOGY & COSMETIC CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 W BRISTOL RD STE 150
FLINT MI
48507-3161
US

IV. Provider business mailing address

4444 W BRISTOL RD STE 150
FLINT MI
48507-3161
US

V. Phone/Fax

Practice location:
  • Phone: 833-322-3376
  • Fax: 248-607-6777
Mailing address:
  • Phone: 833-322-3376
  • Fax: 248-607-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: WASIM NASIR
Title or Position: OWNER
Credential: MD
Phone: 833-322-3376