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MICHIGAN PEDIATRIC ENT ASSOCIATES PLLC NPI 1679631360


NPI Information

NPI: 1679631360
Provider Name: MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC
Classification: Otolaryngology - 207YP0228X
Entity Type: Organization

Specialization: Pediatric Otolaryngology

Address:
7001 ORCHARD LAKE RD
SUITE 320C
WEST BLOOMFIELD, MI
ZIP 48322
Phone: (248) 571-3600
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MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC is a pediatric otolaryngology otolaryngology in West Bloomfield, MI. The provider is a pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC NPI is 1679631360. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

7001 ORCHARD LAKE RD
SUITE 320C
WEST BLOOMFIELD, MI
ZIP 48322-604
Phone: (248) 571-3600
Fax: (248) 973-8560

The provider's authorized official is Lynn Denhardt .
The authorized official title is Practice Manager and has the following contact phone number (248) 847-3210.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 5/18/2016.


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
1207YP0228XOtolaryngologyPediatric Otolaryngology4301026037MICHIGANNo
2207YP0228XOtolaryngologyPediatric Otolaryngology5101010352MICHIGANNo
3207YP0228XOtolaryngologyPediatric Otolaryngology5101009481MICHIGANNo
4207YP0228XOtolaryngologyPediatric Otolaryngology4301085240MICHIGANYes

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
1418929911MEDICAIDMICHIGAN
2040E011990OTHERMICHIGANBCBS OF MI
3418941211MEDICAIDMICHIGAN
4418944011MEDICAIDMICHIGAN
50N10480MEDICARE PINMICHIGAN
60N10480001MEDICARE PINMICHIGAN
70N10480002MEDICARE PINMICHIGAN
8F42236MEDICARE UPINMICHIGAN
9519253910MEDICAIDMICHIGAN
10519559510MEDICAIDMICHIGAN
11B45090MEDICARE UPINMICHIGAN
12418942111MEDICAIDMICHIGAN
13E49864MEDICARE UPINMICHIGAN
14418928011MEDICAIDMICHIGAN
15418937910MEDICAIDMICHIGAN
16519222510MEDICAIDMICHIGAN
170N10480003MEDICARE PINMICHIGAN
180N10480005MEDICARE PINMICHIGAN
19=========OTHERMICHIGANTAX ID#
20418930511MEDICAIDMICHIGAN
21418933210MEDICAIDMICHIGAN
22418935010MEDICAIDMICHIGAN

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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