LEGACY DERMATOLOGY GROUP – NPI #1588019053
Dermatology

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.

LEGACY DERMATOLOGY GROUP is a dermatologist located in WATERFORD TOWNSHIP, MI. NPPES has assigned the NPI number 1588019053 to LEGACY DERMATOLOGY GROUP on May 03, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LEGACY DERMATOLOGY GROUP” is a dba name, the actual legal business name for this organization is LEGACY DERMATOLOGY GROUP PC. The primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

The NPI profile was previously updated about 6 years ago on Apr 30, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LEGACY DERMATOLOGY GROUP below.

NPI Profile for
LEGACY DERMATOLOGY GROUP PC

NPI Number
1588019053
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LEGACY DERMATOLOGY GROUP PC
Doing Business As (dba): LEGACY DERMATOLOGY GROUP
Primary location
1392 S CASS LAKE RD
WATERFORD TOWNSHIP, MI 48328
Phone: (248) 338-6400 Fax: (248) 338-2920
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MICHELLE LEGACY
PRESIDENT
Phone: (248) 338-6400
Updated
Certification Date
Apr 30, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207N00000X
- Dermatology (Primary)
MI 5101017676

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.