Healthcare Provider Details

I. General information

NPI: 1982722047
Provider Name (Legal Business Name): GEORGETOWN DERMATOLOGISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39242 DEQUINDRE RD SUITE 105
STERLING HEIGHTS MI
48310-1764
US

IV. Provider business mailing address

39242 DEQUINDRE RD SUITE 105
STERLING HEIGHTS MI
48310-1764
US

V. Phone/Fax

Practice location:
  • Phone: 586-979-1750
  • Fax: 586-979-4667
Mailing address:
  • Phone: 586-979-1750
  • Fax: 586-979-4667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL SANFORD FRANK
Title or Position: PRESIDENT
Credential: MD
Phone: 586-979-1750