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BLUE WATER CHILDREN'S HEALTH CARE NPI 1962003566


NPI Information

NPI: 1962003566
Provider Name: BLUE WATER CHILDREN'S HEALTH CARE
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
3030 COMMERCE DR
FORT GRATIOT, MI
ZIP 48059
Phone: (810) 385-9559
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BLUE WATER CHILDREN'S HEALTH CARE is a pediatrics in Fort Gratiot, 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. BLUE WATER CHILDREN'S HEALTH CARE NPI is 1962003566. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3030 COMMERCE DR
FORT GRATIOT, MI
ZIP 48059-819
Phone: (810) 385-9559
Fax: (810) 385-9515

The provider's authorized official is Dev Nandamudi .
The authorized official title is Md and has the following contact phone number (810) 385-9559.

The enumeration date for this NPI number is 11/2/2020 and was last updated on 11/2/2020.


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
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: 5/5/2024

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