Healthcare Provider Details

I. General information

NPI: 1811817182
Provider Name (Legal Business Name): MAIDLOW PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13209 ORMOND DR
VAN BUREN TOWNSHIP MI
48111-2237
US

IV. Provider business mailing address

13209 ORMOND DR
VAN BUREN TOWNSHIP MI
48111-2237
US

V. Phone/Fax

Practice location:
  • Phone: 734-255-4772
  • Fax:
Mailing address:
  • Phone:
  • 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: ABIGAIL R MAIDLOW
Title or Position: OWNER
Credential: MD
Phone: 734-255-4772