is a Pediatrics in Detroit, Michigan. practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for is 1114978798. The last update date is .
's current location address is Po Box 781076, Detroit, Michigan. You can contact this provider via phone number 3175284800 and fax number 3178651479. The mailing address for is Po Box 781076, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 781076, Detroit, Michigan |
| Phone Number | 3175284800 |
| Fax Number | 3178651479 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1114978798 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 781076 |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482781076 |
| Phone Number | 3175284800 |
| Fax Number | 3178651479 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 01054193A |
|
Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 391410 | BCBS | ||
| 2647149 | OH | -- | |
| 721901 | IN | ANTHEM TRADITIONAL | |
| 200333720 | IN | -- |
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