Healthcare Provider Details

I. General information

NPI: 1568177012
Provider Name (Legal Business Name): FLUSHING PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S CHERRY ST
FLUSHING MI
48433-2018
US

IV. Provider business mailing address

105 S CHERRY ST
FLUSHING MI
48433-2018
US

V. Phone/Fax

Practice location:
  • Phone: 810-250-4360
  • Fax: 810-963-0133
Mailing address:
  • Phone: 810-250-4360
  • Fax: 810-963-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA HORNING
Title or Position: OWNER
Credential: MD
Phone: 810-250-4360