Great Lakes Pediatrics
Pediatric Adolescent Medicine
Great Lakes Pediatrics is a Warren, Michigan based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
26000 Hoover Rd, 103, Warren, Michigan - 48089-1167. They can be contacted on phone at
586-427-1351.
NPI number (Unique professional ID) for Great Lakes Pediatrics is
1417126715 which was assigned by NPPES on 21 Feb, 2008 and it was last updated on 21 Feb, 2008.
Great Lakes Pediatrics license number is
4301073962 for Pediatrics Adolescent Medicine (2080A0000X) in Michigan.
Great Lakes Pediatrics specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Great Lakes Pediatrics basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Great Lakes Pediatrics |
|---|
Business Address:
Great Lakes Pediatrics address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 26000 Hoover Rd, 103
Warren, MI, 48089-1167
United States |
|---|
| Phone Number : | 586-427-1351 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1417126715 |
|---|
| NPI Entity Type : | Organization |
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| First Enrolment Date : | 21 Feb, 2008 |
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| Last Updated On : | 21 Feb, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Sundus Rummani-askar |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 586-427-1351 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Great Lakes Pediatrics are as mentioned. Primary taxonomy code for Great Lakes Pediatrics is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 4301073962 | MI |
Legacy Identifiers:
Other legacy medical identifiers of Great Lakes Pediatrics such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 4435267 | MEDICAID | MI | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 26000 Hoover Rd, 103
Warren, MI, 48089-1167
United States |
|---|
| Phone Number : | 586-427-1351 |
|---|
Business Location:
Patients can refer following map for directions to
Great Lakes Pediatrics practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.