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GREAT LAKES PEDIATRIC GI CLINIC PLLC NPI 1023758257


NPI Information

NPI: 1023758257
Provider Name: GREAT LAKES PEDIATRIC GI CLINIC PLLC
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
31000 TELEGRAPH RD STE 100
BINGHAM FARMS, MI
ZIP 48025
Phone: (248) 854-5309
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GREAT LAKES PEDIATRIC GI CLINIC PLLC is a pediatric gastroenterology pediatrics in Bingham Farms, MI. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. GREAT LAKES PEDIATRIC GI CLINIC PLLC NPI is 1023758257. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

31000 TELEGRAPH RD STE 100
BINGHAM FARMS, MI
ZIP 48025-321
Phone: (248) 854-5309

The provider's authorized official is Jamal Kriem .
The authorized official title is Owner/authorized Official and has the following contact phone number (248) 854-5309.

The enumeration date for this NPI number is 3/29/2022 and was last updated on 3/29/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0206XPediatricsPediatric GastroenterologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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