Great Lakes Pediatrics

NPI 1417126715 - Pediatrics - 2080A0000X

NPI Details
NPI 1417126715
Enumeration Date 02/21/2008
Last Updated 02/21/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name SUNDUS SUNDUS
Position PRESIDENT
Phone (586) 427-1351
Fax
Practice Location
26000 HOOVER RD
103
WARREN MI, 48089-1167, US
Phone (586) 427-1351
Fax
Business Location
26000 HOOVER RD
103
WARREN MI, 48089-1167, US
Phone (586) 427-1351
Fax
Toxanomy
Taxonomy Code 2080A0000X
License State Michigan
License Number 4301073962
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According to our database, Great Lakes Pediatrics NPI is 1417126715, taxonomy code is 2080A0000X and license number is 4301073962, license state is located at Michigan. Great Lakes Pediatrics physically located at 26000 Hoover Rd, Warren MI, 48089-1167. NPI Number 1033115704 has the healthcare provider type.

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1417126715 NPI number is provided on an as is basis without warranty of any kind. 1417126715 is maintained by the National Plan & Provider Enumeration System. The contents of Great Lakes Pediatrics are for informational purposes only.