Healthcare Provider Details

I. General information

NPI: 1134649387
Provider Name (Legal Business Name): WATCH US GROW PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2363 W. JEFFERSON SUITE # 100
TRENTON MI
48183-2705
US

IV. Provider business mailing address

2363 W JEFFERSON AVE STE 100
TRENTON MI
48183-2705
US

V. Phone/Fax

Practice location:
  • Phone: 734-676-2800
  • Fax: 734-676-4418
Mailing address:
  • Phone: 734-676-2800
  • Fax: 734-676-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HEATHER CADENA
Title or Position: OWNER
Credential: M.D.
Phone: 734-676-2800