CLEAR THE DERMATOLOGY CLINIC PC NPI 1164874616

NPI Information

NPI: 1164874616
Provider Name: CLEAR THE DERMATOLOGY CLINIC PC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
116 W MITCHELL ST
PETOSKEY, MI
ZIP 49770
Phone: (231) 348-0766
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CLEAR THE DERMATOLOGY CLINIC PC is a medical physician assistant in Petoskey, MI. CLEAR THE DERMATOLOGY CLINIC PC NPI is 1164874616. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

116 W MITCHELL ST
PETOSKEY, MI
ZIP 49770-357
Phone: (231) 348-0766

The provider's authorized official is Christy Racignol .
The authorized official title is Billing Coordinator and has the following contact phone number (231) 348-2828.

The enumeration date for this NPI number is 7/8/2016 and was last updated on 8/2/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		4301053221	MICHIGAN	No
2	363AM0700X	Physician Assistant	Medical	5601004147	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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