Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Dermatology Group PC

Organization Dermatology Physician · NPI 1588019053

Legacy Dermatology Group PC is a Dermatology Physician in Waterford, Michigan. Licensed in Michigan. Registered with an NPI since 2016.

Licensed in
MI
In the registry since
2016
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1392 S Cass Lake Rd
Waterford, MI 48328
Phone: (248) 338-6400
Fax: (248) 338-2920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 5101017676 (MI)

Record details

NPI number1588019053
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Legacy — President · (248) 338-6400
Other names Legacy Dermatology Group; Legacy Dermatology Group
NPI enumeratedMay 3, 2016
Last updated in NPPESApril 30, 2020
Certification dateApril 30, 2020
Mailing address1392 S Cass Lake Rd, Waterford, MI 48328

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