Pediatrics PC
Pediatrics in Portage, MI. Organization (NPI-2).
NPI number1265421069
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1265421069
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatrics PC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
Practice location
670 Mall DrPortage, MI 49024-2878
Phone 269-327-1900 · Fax 269-327-1564
Mailing address
670 Mall DrPortage, MI 49024-2878
Phone 269-327-1900 · Fax 269-327-1564
Authorized official
Stephen R Lull
President
2693271900
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Other Pediatrics Physician providers in Portage, MI
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- Natalie M Behrle, MDNPI 1619317955
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- Breastfeeding Support & Wellness PCNPI 1447844030
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All 29 Pediatrics Physician providers in Portage · All 1,955 providers in Portage
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