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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

NPI # 1679631360
LBN Legal business name MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC
Authorized official LYNN DENHARDT - (PRACTICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/05/2006
Last updated 05/18/2016 - About 10 years ago
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
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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