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General NPI Number Information
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NPI Number | 1003821661
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CONSULTANTS OF TROY, P.C.
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 633 SOUTH BLVD E STE 2400
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5471
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Country | US
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Telephone | 248-879-5570
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Fax | 248-879-2235
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Provider Business Mailing Address
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Address Line | 633 SOUTH BLVD E STE 2400
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5471
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Country | US
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Telephone | 248-879-5570
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Fax | 248-879-2235
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Authorized Official
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Title or Position | MD
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Name | ELIZABETH A DUBINA
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Credential |
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Telephone | 248-879-6749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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