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PROMEDICA CENTRAL PHYSICIANS LLC NPI 1083959522


NPI Information

NPI: 1083959522
Provider Name: PROMEDICA CENTRAL PHYSICIANS LLC

Doing Business As: PROMEDICA CHILDREN'S SPECIALTIES

Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
730 N MACOMB ST
SUITE 300
MONROE, MI
ZIP 48162
Phone: (419) 291-7010
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PROMEDICA CENTRAL PHYSICIANS LLC is a pediatric gastroenterology pediatrics in Monroe, MI. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. PROMEDICA CENTRAL PHYSICIANS LLC NPI is 1083959522. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Promedica Children's Specialties.

The provider's business location address is:

730 N MACOMB ST
SUITE 300
MONROE, MI
ZIP 48162-900
Phone: (419) 291-7010
Fax: (419) 479-6917

The provider's authorized official is Kristin Knueven .
The authorized official title is Credentialing Supervisor and has the following contact phone number (567) 585-1969.

The enumeration date for this NPI number is 12/11/2012 and was last updated on 2/5/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0206XPediatricsPediatric GastroenterologyMICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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