Basic Information
| Provider Information | |||||||||
| NPI: | 1073903290 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMKIN | ||||||||
| FirstName: | DAREN | ||||||||
| MiddleName: | JOSHUA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 N CAROLINE ST FL 8 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212870006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109555933 | ||||||||
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| Practice Location | |||||||||
| Address1: | 37605 PEMBROKE AVE | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481521050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345917931 | ||||||||
| FaxNumber: | 7344640335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2015 | ||||||||
| LastUpdateDate: | 06/30/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | D0091410 | MD | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 4301506008 | MI | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.