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General NPI Number Information
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NPI Number | 1215058342
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HEALTH CARE, PLLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 709 S ADAMS ST
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City | MT PLEASANT
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State | MI
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Zip | 48858-2207
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Country | US
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Telephone | 989-772-7774
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Fax | 989-772-7220
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Provider Business Mailing Address
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Address Line | 709 S ADAMS ST
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City | MT PLEASANT
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State | MI
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Zip | 48858-2207
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Country | US
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Telephone | 989-772-7774
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Fax | 989-772-7220
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. RUMANA ANIS BARODAWALLA
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Credential | M.D.
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Telephone | 989-772-7774
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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 | 4301068018
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License Number State | MI
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