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BRENTWOOD PEDIATRICS PC NPI 1013188648


NPI Information

NPI: 1013188648
Provider Name: BRENTWOOD PEDIATRICS PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 23D0367952

Address:
33215 W. SEVEN
BRENTWOOD PEDIATRICS ASSOCIATES
LIVONIA, MI
ZIP 48152
Phone: (248) 478-3200
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BRENTWOOD PEDIATRICS PC is a pediatrics in Livonia, 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. BRENTWOOD PEDIATRICS PC NPI is 1013188648. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

33215 W. SEVEN
BRENTWOOD PEDIATRICS ASSOCIATES
LIVONIA, MI
ZIP 48152
Phone: (248) 478-3200
Fax: (248) 478-3316

The provider's authorized official is Ajey Godbole .
The authorized official title is President and has the following contact phone number (248) 478-3200.

The CLIA number assigned to this NPI record is 23D0367952 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/24/2008 and was last updated on 2/23/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics005826MICHIGANYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E31648MEDICARE UPINMICHIGAN
2H51560MEDICARE UPINMICHIGAN

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: 11/14/2023

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