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EASTSIDE DERMATOLOGY PC
NPI 1326007956
Specialist in Grosse Pointe Woods, MI

Active since March 22, 2006CLIA Certified · 2 labs
20030 MACK AVE, GROSSE POINTE WOODS, MI 48236(313) 884-3380(313) 884-9756 Get Directions Write a Review

NPPES record last updated: January 3, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Eastside Dermatology Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTSIDE DERMATOLOGY PC (NPI 1326007956) is a healthcare organization registered as a specialist in Grosse Pointe Woods, Michigan and active in the NPI registry since March 2006. The organization holds 2 active CLIA laboratory certificates and lists Lisa A Manz-dulac, Owner, as its authorized official.

NPPES Registry Identity

NPI1326007956
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLISA A MANZ DULAC MD & ASSOCIATES PC
Location Address20030 MACK AVEGrosse Pointe Woods, MI 48236-2323
Mailing Address20030 Mack AveGrosse Pointe Woods, MI 48236-2323 · (313) 884-3380 · Fax (313) 884-9756
Phone(313) 884-3380
Fax(313) 884-9756
Organization SubpartNo
Authorized OfficialLisa A Manz-dulacOwner · (313) 884-3380
Enumeration DateMarch 22, 2006
Last NPPES UpdateJanuary 3, 2012
✔ NPI 1326007956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

20030 MACK AVE, Grosse Pointe Woods, MI 48236
Open in Google Maps ↗

Other Names 1

Doing Business AsEastside Dermatology Pc

Other Identifiers 3

Medicare ID-Type UnspecifiedOM75680MI · Medicare Group Number
Other070H24887MI · Bcbs Of Mi Group Number
Other23D0916007MI · Clia Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0916007

Lisa A Manz Dulac, MD Associates PC · Grosse Pointe Woods, MI
Active · expires Jun 11, 2028
CLIA Number23D0916007
Laboratory TypePhysician Office
Certificate Effective DateJune 12, 2026
Certificate Expiration DateJune 11, 2028
Laboratory DirectorLisa Manz Dulac
Laboratory Phone(313) 884-3380
Laboratory LocationLisa A Manz Dulac, MD Associates PC20030 Mack Avenue, Grosse Pointe Woods, MI 48236
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 23D2295804

Eastside Dermatology · New Baltimore, MI
Active · expires Dec 16, 2026
CLIA Number23D2295804
Laboratory TypePhysician Office
Certificate Effective DateDecember 17, 2024
Certificate Expiration DateDecember 16, 2026
Laboratory DirectorDouglas M. Piernick II
Laboratory Phone(313) 884-3380
Laboratory LocationEastside Dermatology32743 23 Mile Road Suite 230, New Baltimore, MI 48047
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LISA ALLYN MANZ DULAC MD
Specialist
20030 MACK AVE
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 884-3380
NATALIA FILIPOF
Specialist
20030 MACK AVE
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 884-3380
KENDALL MORGAN RABAUT FNP-C
Nurse Practitioner
20030 MACK AVE
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 884-3380
DR. DOUGLAS MICHAEL PIERNICK II M.D.
Dermatology (MOHS-Micrographic Surgery)
20030 MACK AVE
GROSSE POINTE WOODS, MI 48236
Wayne County (313) 884-3380

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa A Manz Dulac MD & Associates PC's NPI number?

The NPI number for Lisa A Manz Dulac MD & Associates PC is 1326007956. It was assigned to this organization in the NPPES registry on March 22, 2006. The provider is doing business as Eastside Dermatology PC.

Where is Lisa A Manz Dulac MD & Associates PC located?

Lisa A Manz Dulac MD & Associates PC is located at 20030 Mack Ave, Grosse Pointe Woods, MI 48236. The listed phone number is (313) 884-3380.

What is Lisa A Manz Dulac MD & Associates PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Lisa A Manz Dulac MD & Associates PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Lisa A Manz Dulac MD & Associates PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lisa A Manz Dulac MD & Associates PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa A Manz Dulac MD & Associates PC was last updated on January 3, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.