| Dr Michelle Sue Legacy, DO | |
|
1392 S Cass Lake Rd, Waterford, MI 48328-4741 | |
| (248) 338-6400 | |
| Not Available |
| Full Name | Dr Michelle Sue Legacy |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 17 Years |
| Location | 1392 S Cass Lake Rd, Waterford, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982855110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 5101017676 (Michigan) | Secondary |
| 207N00000X | Dermatology | MI5101017676 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Dermatology Group Pc | 8325338148 | 5 |
| Entity Name | Legacy Dermatology Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588019053 PECOS PAC ID: 8325338148 Enrollment ID: O20160608000042 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michelle Sue Legacy, DO 1392 S Cass Lake Rd, Waterford, MI 48328-4741 Ph: (248) 338-6400 | Dr Michelle Sue Legacy, DO 1392 S Cass Lake Rd, Waterford, MI 48328-4741 Ph: (248) 338-6400 |
Marvin David Siegel, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1095 W Huron St, Waterford, MI 48328 Phone: 248-682-9611 Fax: 248-682-6051 | |
Michael Tobin Siegel, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1095 W Huron St, Waterford, MI 48328 Phone: 248-682-9611 Fax: 248-682-6051 | |
Dr. Cory Joshua Rubin, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2665 Elizabeth Lake Rd, Waterford, MI 48328 Phone: 248-681-9541 Fax: 248-681-9581 |