Provider Demographics
NPI:1952516569
Name:DERMATOLOGY CENTER OF ROCHESTER HILLS, P.C.
Entity Type:Organization
Organization Name:DERMATOLOGY CENTER OF ROCHESTER HILLS, P.C.
Other - Org Name:JOSEPH A. STUTZ, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-651-9500
Mailing Address - Street 1:919 W UNIVERSITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6905
Mailing Address - Country:US
Mailing Address - Phone:248-651-9500
Mailing Address - Fax:248-651-3366
Practice Address - Street 1:919 W UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-6905
Practice Address - Country:US
Practice Address - Phone:248-651-9500
Practice Address - Fax:248-651-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068458207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4114411Medicaid
MI4114411Medicaid
MIG91643Medicare UPIN