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PREMIERE PEDIATRICS PC NPI 1134291982


NPI Information

NPI: 1134291982
Provider Name: PREMIERE PEDIATRICS, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 23D0872627

Address:
7210 N MAIN ST
SUITE 205
CLARKSTON, MI
ZIP 48346
Phone: (248) 625-9755
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PREMIERE PEDIATRICS, PC is a pediatrics in Clarkston, 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. PREMIERE PEDIATRICS, PC NPI is 1134291982. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7210 N MAIN ST
SUITE 205
CLARKSTON, MI
ZIP 48346-575
Phone: (248) 625-9755
Fax: (248) 620-9334

The provider's authorized official is James Charles Shaya .
The authorized official title is President and has the following contact phone number (248) 625-9755.

The CLIA number assigned to this NPI record is 23D0872627 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 4/16/2012.


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
1208000000XPediatricsYes

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: 4/28/2024

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