Provider Demographics
NPI:1639335094
Name:HARPER DERMATOLOGY P.C.
Entity Type:Organization
Organization Name:HARPER DERMATOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:USHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-776-7546
Mailing Address - Street 1:18285 E 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-5802
Mailing Address - Country:US
Mailing Address - Phone:586-776-7546
Mailing Address - Fax:586-447-4910
Practice Address - Street 1:18285 E 10 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5802
Practice Address - Country:US
Practice Address - Phone:586-776-7546
Practice Address - Fax:586-447-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301039212207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB45777OtherBLUE CROSS UPIN
MI0705019201OtherBLUE CROSS NETWORK PIN
MIB45777Medicare UPIN
MI0705019201OtherBLUE CROSS NETWORK PIN