Healthcare Provider Details

I. General information

NPI: 1538010814
Provider Name (Legal Business Name): PRACTICAL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1970 ASHLAND DR STE A
MOUNT PLEASANT MI
48858-1203
US

IV. Provider business mailing address

1970 ASHLAND DR STE A
MOUNT PLEASANT MI
48858-1203
US

V. Phone/Fax

Practice location:
  • Phone: 989-772-1500
  • Fax: 989-772-9301
Mailing address:
  • Phone: 989-772-1500
  • Fax: 989-772-9301

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. ODOMA ACHOR
Title or Position: DOCTOR
Credential: MD
Phone: 989-772-1500