Provider Demographics
NPI:1811605660
Name:DERMATOLOGY & COSMETIC CENTER PLLC
Entity type:Organization
Organization Name:DERMATOLOGY & COSMETIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:NASIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-322-3376
Mailing Address - Street 1:5097 MILLER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1043
Mailing Address - Country:US
Mailing Address - Phone:833-322-3376
Mailing Address - Fax:248-607-6777
Practice Address - Street 1:5097 MILLER RD STE 1
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1043
Practice Address - Country:US
Practice Address - Phone:833-322-3376
Practice Address - Fax:248-607-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty