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HILLSDALE PEDIATRIC CLINIC PC NPI 1972765501


NPI Information

NPI: 1972765501
Provider Name: HILLSDALE PEDIATRIC CLINIC PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 23D2203315

Address:
3755 15 MILE RD
STERLING HEIGHTS, MI
ZIP 48310
Phone: (586) 722-7498
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HILLSDALE PEDIATRIC CLINIC PC is a pediatrics in Sterling Heights, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. HILLSDALE PEDIATRIC CLINIC PC NPI is 1972765501. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3755 15 MILE RD
STERLING HEIGHTS, MI
ZIP 48310-358
Phone: (586) 722-7498
Fax: (586) 722-7499

The provider's authorized official is Michael Sackman .
The authorized official title is Owner and has the following contact phone number (586) 722-7498.

The CLIA number assigned to this NPI record is 23D2203315 - other - county jail with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2008 and was last updated on 6/2/2022.


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
1208000000XPediatricsMS086960MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1350C0107300OTHERMICHIGANBCBSM

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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