Individual provider · NPI-1
Dr. Anne Mare Ice
Pediatrics, Adolescent Medicine · Southfield, MI
NPI number1902839764
StatusActive
Last updated in NPPESMay 9, 2024
Details
- NPI
- 1902839764
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anne Mare Ice
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 7, 2006
- Certification date
- May 9, 2024
- Last updated
- May 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | 4301031683 | MI | Yes |
Practice location
23077 Greenfield Rd Ste 200Southfield, MI 48075-3750
Phone 313-824-1000
Mailing address
22341 W 8 Mile RdDetroit, MI 48219-1217
Phone 313-255-2209 · Fax 313-255-0773
Other practice locations
22341 W 8 Mile Rd
Detroit, MI 48219-1217
Detroit, MI 48219-1217
Phone 313-255-2209 · Fax 313-255-0773
27777 Lahser Rd
Southfield, MI 48034-4751
Southfield, MI 48034-4751
Phone 313-824-1000
12121 Broadstreet Ave
Detroit, MI 48204-1550
Detroit, MI 48204-1550
Phone 313-824-1000
10809 Mack Ave
Detroit, MI 48214-2119
Detroit, MI 48214-2119
Phone 313-824-1000
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.