BASE DERMATOLOGY PC NPI 1902672652

NPI Information

  • NPI: 1902672652
  • Provider Name: BASE DERMATOLOGY, PC
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Organization
  • CLIA Number: 23D0866065
  • Address: 27776 WOODWARD AVE
    ROYAL OAK, MI
    ZIP 48067
  • Phone: (248) 355-5047

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NPI Details

BASE DERMATOLOGY, PC is a mohs-micrographic surgery dermatology in Royal Oak, MI. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. BASE DERMATOLOGY, PC NPI is 1902672652. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

27776 WOODWARD AVE
ROYAL OAK, MI
ZIP 48067-930
Phone: (248) 355-5047
Fax: (248) 355-3511

The provider's authorized official is Bryan Sofen .
The authorized official title is Owner and has the following contact phone number (248) 563-2489.

The CLIA number assigned to this NPI record is 23D0866065 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/4/2023 and was last updated on 7/1/2025.

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
1207N00000XDermatologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11043452139OTHERMICHIGANPERSONAL NPI

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: 11/21/2025

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