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TRAVERSE AREA PEDIATRIC AND ADOLESCENT CLINIC PLC NPI 1821380031


NPI Information

NPI: 1821380031
Provider Name: TRAVERSE AREA PEDIATRIC AND ADOLESCENT CLINIC PLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 23D2030172

Address:
4020 W ROYAL DR
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 421-8099
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TRAVERSE AREA PEDIATRIC AND ADOLESCENT CLINIC PLC is a pediatrics in Traverse City, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. TRAVERSE AREA PEDIATRIC AND ADOLESCENT CLINIC PLC NPI is 1821380031. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4020 W ROYAL DR
TRAVERSE CITY, MI
ZIP 49684-965
Phone: (231) 421-8099
Fax: (231) 421-8599

The provider's authorized official is Karla Marie Smith .
The authorized official title is Managing Partner and has the following contact phone number (231) 421-8099.

The CLIA number assigned to this NPI record is 23D2030172 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/5/2011 and was last updated on 4/16/2013.


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
1208000000XPediatrics2522728MICHIGANYes

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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