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Contact Information

BASE DERMATOLOGY, PC
27776 WOODWARD AVE
ROYAL OAK, MI48067-0930
 Phone: 248-355-5047
 Fax: 248-355-3511
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for BASE DERMATOLOGY, PC

NPI # 1902672652
LBN Legal business name BASE DERMATOLOGY, PC
Authorized official BRYAN SOFEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2023
Last updated 07/01/2025 - About 11 months ago
Identifiers
MI Other 1043452139 PERSONAL NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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