Healthcare Provider Details

I. General information

NPI: 1356508840
Provider Name (Legal Business Name): TROY PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 COOLIDGE HWY SUITE 110
TROY MI
48084-7069
US

IV. Provider business mailing address

PO BOX 745
TROY MI
48099-0745
US

V. Phone/Fax

Practice location:
  • Phone: 248-435-9310
  • Fax: 248-435-9360
Mailing address:
  • Phone: 248-435-9310
  • Fax: 248-435-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301071001
License Number StateMI

VIII. Authorized Official

Name: DR. NEDA SAKER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 248-435-9310