Basic Information
| Provider Information | |||||||||
| NPI: | 1427692276 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | H2 DERMATOLOGY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3272 | ||||||||
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| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486053272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897971400 | ||||||||
| FaxNumber: | 9897974077 | ||||||||
| Practice Location | |||||||||
| Address1: | 5605 COLONY DR N | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486387187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894011463 | ||||||||
| FaxNumber: | 9892665240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2019 | ||||||||
| LastUpdateDate: | 12/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HIRSCHMAN | ||||||||
| AuthorizedOfficialFirstName: | DEREK | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9892891292 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 12/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.