SOUTH LYON DERMATOLOGY, PC
NPI 1407233323
Dermatology in South Lyon, MI

Active since April 29, 2015
26036 PONTIAC TRL, SOUTH LYON, MI 48178(248) 479-2200(248) 479-2682 Get Directions Write a Review

NPPES record last updated: July 16, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Lyon Dermatology, Pc NPPES

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

SOUTH LYON DERMATOLOGY, PC (NPI 1407233323) is a healthcare organization registered as a dermatology in South Lyon, Michigan and active in the NPI registry since April 2015. The organization lists Angela M Clay, Authorized Rep/owner, as its authorized official.

NPPES Registry Identity

NPI1407233323
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOUTH LYON DERMATOLOGY, PC
Location Address26036 PONTIAC TRLSouth Lyon, MI 48178-8050
Mailing Address26036 Pontiac TrlSouth Lyon, MI 48178-8050 · (248) 479-2200 · Fax (248) 479-2682
Fax(248) 479-2682
Organization SubpartNo
Authorized OfficialAngela M ClayAuthorized Rep/owner · (248) 479-2200
Enumeration DateApril 29, 2015
Last NPPES UpdateJuly 16, 2015
NPI 1407233323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
26036 PONTIAC TRL, South Lyon, MI 48178

Other Identifiers 2

Medicaid1407233323MI
Medicare PINMI8758MI

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

Other Providers at the Same Location NPPES 2

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

Physician Assistant (Medical)
26036 PONTIAC TRL
SOUTH LYON, MI 48178
Dermatology
26036 PONTIAC TRL
SOUTH LYON, MI 48178

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 South Lyon Dermatology, PC's NPI number?

The NPI number for South Lyon Dermatology, PC is 1407233323. It was assigned to this organization in the NPPES registry on April 29, 2015.

Where is South Lyon Dermatology, PC located?

South Lyon Dermatology, PC is located at 26036 Pontiac Trl, South Lyon, MI 48178. The listed phone number is (248) 479-2200.

What is South Lyon Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

What insurance does South Lyon Dermatology, 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 South Lyon Dermatology, 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 South Lyon Dermatology, PC was last updated on July 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.