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Contact Information

MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC
7001 ORCHARD LAKE RD
SUITE 320C
WEST BLOOMFIELD, MI48322-3604
 Phone: 248-571-3600
 Fax: 248-973-8560
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MICHIGAN PEDIATRIC ENT ASSOCIATES PLLC · (Female)

NPI # 1679631360
Status Active
Credentials
Entity Individual
Enumeration date 12/05/2006
Last updated 05/18/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 4301026037
  • MI License # 4301085240
  • MI License # 5101009481
  • MI License # 5101010352
  • MI Medicaid 418928011
  • MI Medicaid 418929911
  • MI Medicaid 418930511
  • MI Medicaid 418933210
  • MI Medicaid 418935010
  • MI Medicaid 418937910
  • MI Medicaid 418941211
  • MI Medicaid 418942111
  • MI Medicaid 418944011
  • MI Medicaid 519222510
  • MI Medicaid 519253910
  • MI Medicaid 519559510
  • MI Other 040E011990 BCBS OF MI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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