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Contact Information

GREAT LAKES PEDIATRIC GI CLINIC PLLC
31000 TELEGRAPH RD STE 100
BINGHAM FARMS, MI48025-4321
 Phone: 248-854-5309
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for GREAT LAKES PEDIATRIC GI CLINIC PLLC

NPI # 1023758257
LBN Legal business name GREAT LAKES PEDIATRIC GI CLINIC PLLC
Authorized official JAMAL KRIEM - (OWNER/AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2022
Last updated 03/29/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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