Active NPI 1144459942 Individual Practitioner Male Practitioner

Dr. Mohammad Zarka , DO

Dermatology • Lapeer, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Mohammad Zarka, DO is a certified Dermatology practicing in Lapeer, MI. With approximately 17 years of clinical experience since graduating from Kansas City University Of Physicians And Surgeons in 2009, Dr. Zarka delivers high-quality medical care to the local community at 1057 SUNCREST DR.

Dr. Zarka is affiliated with Zarka Dermatology Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, cygnus dual, per square centimeter, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1057 Suncrest Dr

Lapeer, MI 484464404

Telephone 8102459380

Fax 8102459385

Associated Practice Facility / Clinic

🏢 Sai Ramesh Bikkina Md Pc Facility NPI 1407920846

Medicare Profile & Education

Medical School

Kansas City University Of Physicians And Surgeons

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Lapeer, MI

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -15.5 yrs vs City Avg

City Avg: 32.5 Yrs

State Avg: 22.2 Yrs

Regional Practice Density

3 Specialists

Practicing in Lapeer, MI (493 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

63.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Zarka (17 Years) 17 Yrs

Lapeer Specialty Average (32.5 Years) 32.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,241	174	$15.10	$5.98
Q4282 Cygnus dual, per square centimeter	540	55	$1909.60	$791.26
99213 Established patient office or other outpatient visit, typically 15 minutes	519	391	$211.10	$85.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	458	458	$261.57	$105.72
17000 Destruction of skin growth	288	231	$156.36	$55.81
Q4196 Puraply am, per square centimeter	220	14	$239.17	$102.50
17110 Destruction of up to 14 skin growths	198	153	$257.87	$100.43
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	184	53	$2.41	$0.97
11102 Tangential biopsy of single skin lesion	184	166	$226.88	$85.92
11901 Injection into skin growth, more than 7 growths	136	29	$160.64	$64.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	112	104	$131.02	$53.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	107	53	$296.30	$116.56
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	88	78	$1540.06	$601.16
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	78	50	$355.56	$101.08
11103 Biopsy of related skin growth, each additional growth	75	54	$114.48	$46.17
11104 Punch biopsy, first skin growth	69	67	$281.77	$114.12
17004 Destruction of precancer skin growth, 15 or more growths	63	49	$392.83	$154.76
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	38	34	$1451.65	$578.11
15271 Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less	32	20	$362.04	$101.51
11900 Injection into skin growth, 1-7 growths	32	28	$130.94	$46.86
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	29	26	$1101.45	$265.39
99202 New patient office or other outpatient visit, typically 20 minutes	26	26	$166.06	$65.49
36415 Insertion of needle into vein for collection of blood sample	24	16	$15.00	$8.65
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	24	24	$926.77	$304.53
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	24	22	$938.35	$382.15
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	21	21	$637.42	$136.68
17111 Destruction of skin growth, 15 or more growths	20	15	$310.04	$117.11
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$392.13	$159.58
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	15	15	$924.68	$283.05
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	14	$707.70	$282.40
11105 Punch biopsy, each additional skin growth	14	13	$140.35	$55.26
69100 Biopsy of ear	13	13	$203.59	$71.44
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	11	11	$261.20	$80.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	879	114	$12.90	$6.21
99213 Established patient office or other outpatient visit, typically 15 minutes	440	329	$173.75	$85.17
Q4196 Puraply am, per square centimeter	326	16	$206.43	$101.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	226	226	$215.78	$106.65
17000 Destruction of skin growth	205	148	$127.89	$51.95
17110 Destruction of up to 14 skin growths	201	143	$213.98	$102.20
Q4159 Affinity, per square centimeter	168	12	$783.13	$385.30
11102 Tangential biopsy of single skin lesion	159	148	$192.78	$85.79
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	106	37	$2.80	$1.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	43	$242.34	$117.10
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	74	59	$1299.28	$570.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	70	64	$108.62	$52.99
11901 Injection into skin growth, more than 7 growths	68	18	$133.18	$63.11
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	48	17	$305.82	$122.25
11103 Biopsy of related skin growth, each additional growth	46	35	$95.98	$46.38
11104 Punch biopsy, first skin growth	36	35	$239.52	$114.58
11900 Injection into skin growth, 1-7 growths	29	21	$109.38	$48.27
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	27	23	$818.12	$320.52
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$139.26	$67.54
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	24	15	$785.72	$386.57
17004 Destruction of precancer skin growth, 15 or more growths	23	18	$323.20	$159.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$306.88	$161.08
13151 Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm	15	15	$818.20	$228.12
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	15	$469.68	$115.54
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	13	11	$1218.06	$599.29
69100 Biopsy of ear	11	11	$185.06	$78.64
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$329.46	$118.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	798	107	$25.00	$6.38
99213 Established patient office or other outpatient visit, typically 15 minutes	396	293	$116.62	$87.46
17110 Destruction of up to 14 skin growths	245	186	$147.09	$104.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	237	237	$165.00	$109.36
17000 Destruction of skin growth	177	129	$105.00	$51.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	163	125	$142.02	$120.76
11102 Tangential biopsy of single skin lesion	153	133	$145.00	$83.23
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	118	36	$25.00	$1.15
11901 Injection into skin growth, more than 7 growths	109	31	$100.00	$65.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$225.00	$161.16
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	56	46	$897.51	$559.74
11103 Biopsy of related skin growth, each additional growth	49	40	$80.00	$49.07
17111 Destruction of skin growth, 15 or more growths	43	23	$205.00	$122.82
13151 Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm	28	25	$580.00	$219.64
17004 Destruction of precancer skin growth, 15 or more growths	26	23	$330.00	$162.57
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	21	18	$575.00	$376.41
11900 Injection into skin growth, 1-7 growths	18	18	$85.00	$44.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$70.00	$54.10
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$240.00	$119.76
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	16	15	$130.00	$106.88
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	14	$305.00	$118.53
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	13	13	$285.00	$255.00
11104 Punch biopsy, first skin growth	13	13	$175.00	$120.74
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	11	11	$1050.00	$726.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	567	90	$25.00	$6.17
99213 Established patient office or other outpatient visit, typically 15 minutes	487	310	$100.00	$88.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	217	217	$165.00	$108.80
17110 Destruction of up to 14 skin growths	179	137	$145.00	$104.64
17000 Destruction of skin growth	140	103	$105.00	$51.96
11102 Tangential biopsy of single skin lesion	134	119	$145.00	$85.89
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	100	29	$25.00	$1.26
11901 Injection into skin growth, more than 7 growths	75	30	$100.00	$68.13
11103 Biopsy of related skin growth, each additional growth	54	34	$80.00	$50.71
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	47	47	$120.00	$91.98
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	43	37	$897.51	$566.35
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	28	20	$575.00	$384.40
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	23	17	$305.00	$120.23
17111 Destruction of skin growth, 15 or more growths	21	14	$205.00	$121.64
17004 Destruction of precancer skin growth, 15 or more growths	18	16	$330.00	$160.17
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	18	18	$130.00	$129.02
11900 Injection into skin growth, 1-7 growths	18	13	$85.00	$46.85
11104 Punch biopsy, first skin growth	15	15	$175.00	$124.93
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	14	13	$1050.00	$741.59
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	12	12	$740.00	$347.69
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	11	11	$537.19	$393.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	462	281	$99.97	$71.97
17003 Destruction of precancer skin growth, 2-14 growths	433	59	$25.00	$5.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	181	181	$165.00	$104.02
17110 Destruction of up to 14 skin growths	144	92	$145.00	$104.07
11102 Tangential biopsy of single skin lesion	125	108	$145.00	$85.10
17000 Destruction of skin growth	98	72	$105.00	$54.05
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	41	15	$25.00	$1.45
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	34	31	$897.51	$556.09
11103 Biopsy of related skin growth, each additional growth	32	27	$80.00	$50.92
11901 Injection into skin growth, more than 7 growths	28	11	$100.00	$66.15
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	26	21	$575.00	$391.25
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	17	$305.00	$119.12
17004 Destruction of precancer skin growth, 15 or more growths	21	17	$330.00	$151.56
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	20	19	$1050.00	$702.27
17111 Destruction of skin growth, 15 or more growths	18	15	$205.00	$120.76
11900 Injection into skin growth, 1-7 growths	15	12	$85.00	$48.48
11104 Punch biopsy, first skin growth	13	13	$175.00	$121.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	434	263	$99.64	$71.03
17003 Destruction of precancer skin growth, 2-14 growths	307	57	$24.43	$5.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	180	180	$164.67	$104.42
17110 Destruction of up to 14 skin growths	130	92	$144.69	$102.45
11102 Tangential biopsy of single skin lesion	111	97	$144.68	$80.60
17000 Destruction of skin growth	110	78	$104.64	$50.81
11103 Biopsy of related skin growth, each additional growth	31	26	$79.68	$50.61
11104 Punch biopsy, first skin growth	30	28	$174.67	$117.91
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	28	22	$24.64	$1.57
17004 Destruction of precancer skin growth, 15 or more growths	27	21	$330.00	$145.06
11901 Injection into skin growth, more than 7 growths	25	15	$99.60	$63.92
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	24	24	$129.17	$126.88
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	24	22	$376.88	$147.20
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	23	20	$574.78	$404.13
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	18	17	$774.72	$478.65
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	15	13	$129.33	$91.96
17111 Destruction of skin growth, 15 or more growths	15	12	$205.00	$124.15
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	11	$305.00	$118.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	387	221	$95.00	$69.29
17003 Destruction of precancer skin growth, 2-14 growths	372	55	$20.00	$5.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	147	147	$160.00	$102.10
11100 Biopsy of single growth of skin and/or tissue	143	130	$130.00	$93.56
17110 Destruction of up to 14 skin growths	96	76	$140.00	$103.83
17000 Destruction of skin growth	94	69	$100.00	$53.58
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	85	54	$125.00	$91.41
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	39	38	$125.00	$123.15
11101 Biopsy of each additional growth of skin and/or tissue	39	35	$60.00	$31.74
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	34	24	$95.00	$68.17
17004 Destruction of precancer skin growth, 15 or more growths	27	25	$325.00	$139.67
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	23	20	$570.00	$401.93
17000 Destruction of skin growth	20	17	$100.00	$49.17
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	18	11	$20.00	$1.74
17111 Destruction of skin growth, 15 or more growths	14	11	$200.00	$125.41
99344 New patient home visit, typically 1 hour	12	12	$463.43	$188.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	563	76	$20.00	$5.15
99213 Established patient office or other outpatient visit, typically 15 minutes	336	194	$95.00	$67.54
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	144	144	$160.00	$99.54
17000 Destruction of skin growth	136	96	$100.00	$50.20
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	112	56	$125.00	$85.99
17003 Destruction of precancer skin growth, 2-14 growths	100	14	$20.00	$2.34
17110 Destruction of up to 14 skin growths	98	79	$140.00	$96.14
11100 Biopsy of single growth of skin and/or tissue	81	74	$130.00	$86.91
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	36	19	$20.00	$1.73
99344 New patient home visit, typically 1 hour	34	34	$463.43	$171.42
17000 Destruction of skin growth	33	20	$100.00	$49.99
11101 Biopsy of each additional growth of skin and/or tissue	30	21	$60.00	$30.47
17004 Destruction of precancer skin growth, 15 or more growths	29	23	$325.00	$137.89
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	27	$65.00	$40.01
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	25	25	$125.00	$121.04
11901 Injection into skin growth, more than 7 growths	24	11	$95.00	$60.88
17111 Destruction of skin growth, 15 or more growths	20	15	$200.00	$120.11
11200 Removal of skin tag, 1-15 skin tags	15	12	$120.00	$73.18
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	14	13	$322.45	$120.82

Medical Specialties & State Licenses

CMS Verified: 2023-03-22

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License MI 5101018443

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Zarka Dermatology Pllc

1057 Suncrest Dr, Lapeer, MI 484464404

Phone: 8102459380

Zarka Dermatology Pllc

1500 N Main St, Lapeer, MI 484461352

Phone: 8102459380

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dairlis Rigg , MA

Audiologist

NPI 1376275156

Master of Arts

Kathryn Washington , PHYSICAL THERAPIST

Physical Therapist

NPI 1396234472

PHYSICALTHERAPIST

Gela May , OT

Occupational Therapist

NPI 1740781277

Occupational Therapist

Dr. Sai Bikkina , MD

Internal Medicine - Hematology & Oncology

NPI 1982782496

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location March 22, 2023

Registered at 1057 SUNCREST DR, LAPEER, MI 484464404 (Tel: 8102459380)

📍

Updated Business Mailing Address March 22, 2023

Registered at 1057 SUNCREST DR, LAPEER, MI 484464404 (Tel: 8102459380)

📍

Updated Practice Location December 05, 2022

Registered at 1500 N MAIN ST, LAPEER, MI 484461352 (Tel: 8102459380)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 05, 2022

Dermatology (License #5101018443 in MI)

✅

NPI Profile Active December 01, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location December 01, 2015

Registered at 1333 IMLAY CITY RD, LAPEER, MI 484463113 (Tel: 8102459380)

📍

Updated Business Mailing Address December 01, 2015

Registered at 1575 W BIG BEAVER RD, SUITE C, TROY, MI 480843536 (Tel: 2486437677)

👤

Provider Name / Credentials Updated December 01, 2015

Recorded as MOHAMMAD ZARKA, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2015

Internal Medicine (License #5173350918 in MI)

🟢

Initial NPI Registration & Enumeration July 14, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1144459942

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 14, 2009

Last Update: March 22, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1057 Suncrest Dr

Lapeer, MI 484464404

Phone: 8102459380

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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