Wolverine Dermatology, Pc

LBN: Wolverine Dermatology, Pc
Wolverine Dermatology, Pc is an health care organization with primary practice located at 1673 Gezon Pkwy Sw , Wyoming MI 49519-9519. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Wolverine Dermatology, Pc can be contacted via phone (616) 243-3376, or through Freeland, Ryan Dale via phone (210) 632-0341.

Contact Information

Primary practice address
1673 Gezon Pkwy Sw Wyoming MI 49519-9519
Phone: (616) 243-3376
Fax: (616) 243-3377
Website:
Map and Directions
Authorized official contact:
Name: Freeland, Ryan Dale Doctor of Medicine (MD)
Phone: (210) 632-0341

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 4301084275 Michigan

Profile Details

NPI number 1679085161
LBN Legal business name Wolverine Dermatology, Pc
DBA Doing business as
Authorized official Freeland, Ryan Dale Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2017
Last updated Feb 28th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1679085161 NPPES
Michigan Other 23D2141314 CLIA
Michigan Other 4301084275 CLIA

Popular Providers