Unknown Individual – Pediatrics Physician, NPI 1124013750
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
22201, Moross Road, Detroit, Wayne County, Michigan, 48236, United States
SUITE 270
DETROIT, MI 482362169
Phone: (313) 343-3481
Fax: (313) 343-7937
Type: Mailing
Romeo Plank Road, Waldenburg, Macomb Township, Macomb County, Michigan, 48044, United States
SUITE 205
MACOMB, MI 480445742
Phone: (586) 226-6250
Fax: (586) 226-6255
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48236)
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