Healthcare Provider Details

I. General information

NPI: 1700498946
Provider Name (Legal Business Name): POSITIVELY PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N BRIDGE ST STE D
LINDEN MI
48451-8823
US

IV. Provider business mailing address

1320 KINGS CARRIAGE RD
GRAND BLANC MI
48439-8785
US

V. Phone/Fax

Practice location:
  • Phone: 248-939-2482
  • Fax:
Mailing address:
  • Phone: 248-939-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TIMOTHY G PURMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 248-939-2482