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General NPI Number Information
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NPI Number | 1235636408
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Entity Type | Organization
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Legal Business Name | HEALTHY KIDS PLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 18060 CONANT ST
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City | DETROIT
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State | MI
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Zip | 48234-1628
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Country | US
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Telephone | 313-826-0953
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Fax | 313-826-0766
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Provider Business Mailing Address
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Address Line | 18060 CONANT ST
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City | DETROIT
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State | MI
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Zip | 48234-1628
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Country | US
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Telephone | 313-826-0953
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Fax | 313-826-0766
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Authorized Official
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Title or Position | BILLING MGR
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Name | MRS. NIDAL AHMED
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Credential |
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Telephone | 313-999-9510
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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 | 4301085754
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License Number State | MI
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