WATERFORD PEDIATRICS – NPI #1104082148
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

WATERFORD PEDIATRICS is a provider located in WATERFORD TOWNSHIP, MI. NPPES has assigned the NPI number 1104082148 to WATERFORD PEDIATRICS on July 30, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

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 WATERFORD PEDIATRICS below.

NPI Profile for
WATERFORD PEDIATRICS

NPI Number
1104082148
Enumeration Date

(about 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WATERFORD PEDIATRICS
Primary location
4185 HIGHLAND RD
WATERFORD TOWNSHIP, MI 48328
Phone: (248) 648-8930 Fax: (248) 648-8931
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
VICKI INMAN
BILLING MGR
Phone: (248) 666-4266
Updated
Identifiers

Identifiers for WATERFORD PEDIATRICS

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.

See identifiers
DescriptionIssuerStateIdentifier
OTHERBCBS0634011
OTHERCARECHOICES120911
OTHERHEALTH PLAN15486
OTHERMCAREC7543
OTHERMIDWEST021121
MEDICAIDMI4149524
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
208D00000X
- General Practice (Primary)
MI MK057394

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.