ADVANCED DERMATOLOGY PLLC
NPI 1538192018
Dermatology in Saint Joseph, MI

Active since July 08, 2006
300 E MAIDEN LN, SAINT JOSEPH, MI 49085(269) 429-7546(269) 429-0807 Get Directions Write a Review

NPPES record last updated: March 25, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Advanced Dermatology Pllc NPPES

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

ADVANCED DERMATOLOGY PLLC (NPI 1538192018) is a healthcare organization registered as a dermatology in Saint Joseph, Michigan and active in the NPI registry since July 2006. The organization lists Mark A Kutriata, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1538192018
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY PLLC
Location Address300 E MAIDEN LNSaint Joseph, MI 49085-8516
Mailing Address300 E Maiden LnSaint Joseph, MI 49085-8516 · (269) 429-7546 · Fax (269) 429-0807
Fax(269) 429-0807
Organization SubpartNo
Authorized OfficialMark A KutriataOwner/provider · (269) 429-7546
Enumeration DateJuly 8, 2006
Last NPPES UpdateMarch 25, 2010
NPI 1538192018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in MI · 5101012454
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.
300 E MAIDEN LN, Saint Joseph, MI 49085

Other Identifiers 6

Other0A10115MI · Bcbsm Group
Medicaid350460011MI
Medicare PIN0N90840
Medicare PIN0N90850
OtherCG9582MI · Palmetto Gba Group
Other0751100205Blue Cross

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

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.

Dermatology (MOHS-Micrographic Surgery)
300 E MAIDEN LN
SAINT JOSEPH, MI 49085
Physician Assistant
300 E MAIDEN LN
SAINT JOSEPH, MI 49085
Physician Assistant
300 E MAIDEN LN
SAINT JOSEPH, MI 49085
Physician Assistant
300 E MAIDEN LN
SAINT JOSEPH, MI 49085

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 Advanced Dermatology PLLC's NPI number?

The NPI number for Advanced Dermatology PLLC is 1538192018. It was assigned to this organization in the NPPES registry on July 8, 2006.

Where is Advanced Dermatology PLLC located?

Advanced Dermatology PLLC is located at 300 E Maiden Ln, Saint Joseph, MI 49085. The listed phone number is (269) 429-7546.

What is Advanced Dermatology PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Advanced Dermatology PLLC was last updated on March 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.