Organization · Type 2 NPI

Great Lakes Pediatrics

Pediatric Adolescent Medicine Physician · Warren, MI

NPI number 1417126715 Active

About NPI 1417126715

Great Lakes Pediatrics's National Provider Identifier is 1417126715, issued on Feb 21, 2008. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Warren, MI. The record was last updated on Feb 21, 2008.