Organization · Type 2 NPI

McLaren Macomb

Pediatric Neurodevelopmental Disabilities Physician · Clinton Township, MI

NPI number 1821049990 Active

Practice location

43900 Garfield Rd, Ste. 201
Clinton Township, MI 48038

Fax (586) 412-5116

Specialties and licenses

Taxonomy	Code	License
Pediatric Neurodevelopmental Disabilities Physician Primary	2080P0008X	None listed
Pediatric Cardiology Physician	2080P0202X	None listed

Pediatric Neurodevelopmental Disabilities Physician: A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions.

25 other providers at this address

NPI record

NPI: 1821049990
Entity type: Organization (Type 2)
Issued: May 13, 2006
Last updated: May 23, 2018
Status: Active

Other names

<unavail>
Pediatric Specialty Group · doing business as
Pediatric Specialty Group · doing business as

Authorized official

Mrs. Thomas M Brisse
CEO
(586) 493-8083

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1821049990

McLaren Macomb's National Provider Identifier is 1821049990, issued on May 13, 2006. The primary taxonomy on file is Pediatric Neurodevelopmental Disabilities Physician (2080P0008X), and the practice location is in Clinton Township, MI. The record was last updated on May 23, 2018.