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HILLSDALE PEDIATRICS CLINIC PC NPI 1992937148


NPI Information

NPI: 1992937148
Provider Name: HILLSDALE PEDIATRICS CLINIC PC

Former Legal Business Name: HILLSDALE PEDIATRICS

Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
451 HIDDEN MEADOWS DR
SUITE 200
HILLSDALE, MI
ZIP 49242
Phone: (517) 437-8325
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HILLSDALE PEDIATRICS CLINIC PC is an adolescent medicine pediatrics in Hillsdale, MI. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. HILLSDALE PEDIATRICS CLINIC PC NPI is 1992937148. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Hillsdale Pediatrics.

The provider's business location address is:

451 HIDDEN MEADOWS DR
SUITE 200
HILLSDALE, MI
ZIP 49242-812
Phone: (517) 437-8325
Fax: (517) 437-8327

The provider's authorized official is Michael Sackman .
The authorized official title is Owner and has the following contact phone number (517) 437-8325.

The enumeration date for this NPI number is 8/20/2009 and was last updated on 8/6/2013.


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
12080A0000XPediatricsAdolescent MedicineMS086960MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1105336218MEDICAIDMICHIGAN
2MI3873MEDICARE PINMICHIGAN
33503013872OTHERBCBSM

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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