Provider Demographics
NPI:1821034794
Name:RICHARD A STONE M.D. PLLC
Entity Type:Organization
Organization Name:RICHARD A STONE M.D. PLLC
Other - Org Name:STONE DERMATOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-226-7200
Mailing Address - Street 1:14460 LAKESIDE CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1348
Mailing Address - Country:US
Mailing Address - Phone:586-685-3285
Mailing Address - Fax:586-685-3286
Practice Address - Street 1:14460 LAKESIDE CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1348
Practice Address - Country:US
Practice Address - Phone:586-685-3285
Practice Address - Fax:586-685-3286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS039621207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB43859Medicare UPIN
MION40400Medicare ID - Type Unspecified