Organization · Type 2 NPI
Vernor Pediatric PC
Pediatric Adolescent Medicine Physician · Detroit, MI
NPI number
1073010625
Active
Practice location
4607 W Vernor Hwy
Detroit, MI 48209-2117
Fax (313) 554-3303
Mailing address
26206 W 12 Mile Rd Ste 106
Southfield, MI 48034-1799
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | NK069655 (MI) |
Pediatric Adolescent Medicine Physician: 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.
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About NPI 1073010625
Vernor Pediatric PC's National Provider Identifier is 1073010625, issued on Apr 10, 2018. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Detroit, MI. The record was last updated on Jun 10, 2021.