ANNE MARE ICE – NPI #1902839764
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

ANNE MARE ICE is a physician located in SOUTHFIELD, MI. NPPES has assigned the NPI number 1902839764 to ANNE MARE ICE on July 07, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI Registry, there are 4 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 2 years ago on May 09, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANNE MARE ICE below.

NPI Profile for
ANNE MARE ICE

NPI Number
1902839764
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
ANNE MARE ICE
Primary location
23077 GREENFIELD RD STE 200
SOUTHFIELD, MI 48075-3750
Phone: (313) 824-1000 Fax:
4 Other location(s):
10809 Mack Ave
Detroit, MI 48214-2119
Phone: (313) 824-1000 Ext: 1
12121 Broadstreet Ave
Detroit, MI 48204-1550
Phone: (313) 824-1000 Ext: 2
22341 W 8 Mile Rd
Detroit, MI 48219-1217
Phone: (313) 255-2209 Ext: 234
Fax: (313) 255-0773
27777 Lahser Rd
Southfield, MI 48034-4751
Phone: (313) 824-1000 Ext: 2
Mailing address
22341 W 8 MILE RD
DETROIT, MI 48219-1217
Phone: (313) 255-2209 Fax: (313) 255-0773
Sole Proprietor
Yes
Updated
Certification Date
May 09, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ANNE MARE ICE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMI1066910
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)
MI 4301031683

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.