Great Lakes Pediatric Associates

LBN: Great Lakes Pediatric Associates
Great Lakes Pediatric Associates is an health care organization with primary practice located at 3400 Pinetree Rd Ste 102, Lansing MI 48911-4286. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Great Lakes Pediatric Associates can be contacted via phone (517) 887-3000, or through Charles, Beth Ileen via phone (517) 887-3000.

Contact Information

Primary practice address
3400 Pinetree Rd Ste 102 Lansing MI 48911-4286
Phone: (517) 887-3000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Charles, Beth Ileen
Phone: (517) 887-3000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301049233 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301063626 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301078945 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301086445 Michigan

Profile Details

NPI number 1023342474
LBN Legal business name Great Lakes Pediatric Associates
DBA Doing business as
Authorized official Charles, Beth Ileen
Entity Organization
Organization subpart 1 No
Enumeration date Oct 1st, 2009
Last updated Oct 1st, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023342474 NPPES
Michigan MEDICAID 3069367
Michigan MEDICAID 3080275
Michigan MEDICAID 4366885
Michigan Other 1144338443
Michigan Other 1144338450
Michigan Other 1730297045
Michigan Other 1831309921

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