Healthcare Provider Details

I. General information

NPI: 1255439295
Provider Name (Legal Business Name): NORTHPOINTE PEDIATRICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30061 SCHOENHERR RD SUITE A
WARREN MI
48088-3133
US

IV. Provider business mailing address

30061 SCHOENHERR RD SUITE A
WARREN MI
48088-3133
US

V. Phone/Fax

Practice location:
  • Phone: 586-558-2111
  • Fax: 586-558-2169
Mailing address:
  • Phone: 586-558-2111
  • Fax: 586-558-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KAY LYNN ASPENLEITER
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-558-2111