IndividualActive
Joan Griner Licht, MD
NPI 1710902945 · Procedural Dermatology Physician · Traverse City, MI
Provider details
- NPI number
- 1710902945
- Entity type
- Individual
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- JG058054 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3643 W Front St Ste a
Traverse City, MI 49684-7760
Phone: (231) 935-0620
Fax: (231) 935-0626
Approximate (ZIP-level) locationGet directions
Mailing address
3643 W Front St
Traverse City, MI 49684-7759
Registry dates
- Enumerated
- 2006-07-12
- Last updated
- 2014-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.