Provider Demographics
NPI:1619217478
Name:OAKLAND HILLS DERMATOLOGY PC
Entity Type:Organization
Organization Name:OAKLAND HILLS DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOFER
Authorized Official - Middle Name:N
Authorized Official - Last Name:BUATTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-756-3500
Mailing Address - Street 1:3400 AUBURN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3396
Mailing Address - Country:US
Mailing Address - Phone:482-858-2255
Mailing Address - Fax:248-499-7436
Practice Address - Street 1:3400 AUBURN RD STE 100
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3396
Practice Address - Country:US
Practice Address - Phone:248-858-2255
Practice Address - Fax:248-499-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2023-08-30
Deactivation Date:2023-08-22
Deactivation Code:
Reactivation Date:2023-08-30
Provider Licenses
StateLicense IDTaxonomies
MI5101016099207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty