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CONCIERGE DERMATOLOGY & SKIN SURGERY CENTER
NPI 1417442898
Dermatology - MOHS-Micrographic Surgery in Hancock, MI

Active since June 27, 2018CLIA 23D2256333 · Certificate of Compliance
500 CAMPUS DR, HANCOCK, MI 49930(906) 362-7546(413) 269-8079 Get Directions Write a Review

NPPES record last updated: October 31, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 31, 2018, Jun 27, 2018 (2 updates tracked since 2018).

About Concierge Dermatology & Skin Surgery Center NPPES

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

CONCIERGE DERMATOLOGY & SKIN SURGERY CENTER (NPI 1417442898) is a healthcare organization registered as a mohs-micrographic surgery in Hancock, Michigan and active in the NPI registry since June 2018. The organization holds a CLIA Certificate of Compliance certificate valid through March 12, 2027, maintains 3 additional practice locations, and lists Mercy A Odueyungbo, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1417442898
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameCONCIERGE DERMATOLOGY & SKIN SURGERY CENTER
Location Address500 CAMPUS DRHancock, MI 49930
Mailing Address540 S Lakeshore Blvd Unit 34Marquette, MI 49855-4631 · (708) 833-9990
Phone(906) 362-7546
Fax(413) 269-8079
Organization SubpartNo
Authorized OfficialMercy A OdueyungboAuthorized Official · (906) 362-7546
Enumeration DateJune 27, 2018
Last NPPES UpdateOctober 31, 20182 updates tracked since enumeration
✔ NPI 1417442898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
500 CAMPUS DR, Hancock, MI 49930
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Secondary Practice Locations 3

Location 11500 Sandpoint RdMunising, MI 49862-1406 · Phone (709) 833-9990
Location 218341 US Highway 41Lanse, MI 49946-8024 · Phone (906) 362-7546 · Fax (413) 269-8079
Location 3710 S Lincoln RdEscanaba, MI 49829-1292 · Phone (906) 362-7546 · Fax (413) 269-8079

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 of Compliance 23D2256333

Concierge Dermatology & Skin Surgery Center · Marquette, MI
Active · expires Mar 12, 2027
CLIA Number23D2256333
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorMercy A. Odueyungbo
Laboratory Phone(906) 362-7546
Laboratory LocationConcierge Dermatology & Skin Surgery Center101 W Washington Street Suite 105, Marquette, MI 49855
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 20

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

MERCEDES A MAKI PA
Physician Assistant (Medical)
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1000
COLLEEN MARIE VALLAD-HIX DO
Pediatrics
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1700
MICHAEL CONRAD SALMI CRNA
Nurse Anesthetist, Certified Registered
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1000
DOUGLAS MCKENZIE MD
Family Medicine
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1060
TIMOTHY SEARS MD
Surgery
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1040
VANDANA CHATTERJEE MD
Internal Medicine
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1730
MS. COURTNEY HOLLY SMITH PA
Physician Assistant
500 CAMPUS DR, EMERGENCY DEPARTMENT
HANCOCK, MI 49930
Houghton County (906) 483-1000
TAYLOR LANDERS CNM
Advanced Practice Midwife
500 CAMPUS DR
HANCOCK, MI 49930
Houghton County (906) 483-1000

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 Concierge Dermatology & Skin Surgery Center's NPI number?

The NPI number for Concierge Dermatology & Skin Surgery Center is 1417442898. It was assigned to this organization in the NPPES registry on June 27, 2018.

Where is Concierge Dermatology & Skin Surgery Center located?

Concierge Dermatology & Skin Surgery Center is located at 500 Campus Dr, Hancock, MI 49930. The listed phone number is (906) 362-7546.

What is Concierge Dermatology & Skin Surgery Center's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Concierge Dermatology & Skin Surgery Center hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 23D2256333) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Concierge Dermatology & Skin Surgery Center accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Concierge Dermatology & Skin Surgery Center 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 Concierge Dermatology & Skin Surgery Center was last updated on October 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.