MEDICARE: ALLEN N.TESSER, M.D, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	AT035199	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AT035199	OTHER	MI	STATE LICENSE

General Provider Information

NPI Number	:	1285835215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN N.TESSER, M.D, P.C.

Provider Business Mailing Address
First Line	:	3058 METROPOLITAN PKWY
Second Line	:	SUITE 208
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3671
Country	:	US
Telephone Number	:	586-939-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3058 METROPOLITAN PKWY
Second Line	:	SUITE 208
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3671
Country	:	US
Telephone Number	:	586-939-6400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALLLEN TESSER
Credential	:	M D
Telephone Number	:	586-939-6400

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	12/27/2007

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Directions to “ALLEN N.TESSER, M.D, P.C. ” Practice Location

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