Healthcare Provider Details

I. General information

NPI: 1669701124
Provider Name (Legal Business Name): BEST KIDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2009
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 STONE ST SUITE 5
PORT HURON MI
48060-3569
US

IV. Provider business mailing address

1107 STONE ST SUITE 5
PORT HURON MI
48060-3569
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-9300
  • Fax: 810-985-9393
Mailing address:
  • Phone: 810-985-9300
  • Fax: 810-985-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101017094
License Number StateMI

VIII. Authorized Official

Name: DR. SARAH JO PASIA
Title or Position: OWNER
Credential: D.O.
Phone: 810-300-2807