Healthcare Provider Details
I. General information
NPI: 1114719234
Provider Name (Legal Business Name): MESSENGER & SONS DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 LAKE LANSING RD STE A
LANSING MI
48912-3752
US
IV. Provider business mailing address
1515 LAKE LANSING RD STE A
LANSING MI
48912-3752
US
V. Phone/Fax
- Phone: 517-487-0128
- Fax: 517-487-2639
- Phone: 517-487-0128
- Fax: 517-487-2639
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NI0002X |
| Taxonomy | Clinical & Laboratory Dermatological Immunology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0006X |
| Taxonomy | Clinical Pathology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ND0900X |
| Taxonomy | Dermatopathology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NS0135X |
| Taxonomy | Procedural Dermatology Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ND0101X |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BETH
A
HAMIEL
Title or Position: MANAGER
Credential:
Phone: 517-487-0128