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General NPI Number Information
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NPI Number | 1306003538
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Entity Type | Organization
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Legal Business Name | GREENWOOD PEDIATRICS
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 720 W FRANKLIN ST SUITE 1
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City | JACKSON
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State | MI
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Zip | 49201-1674
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Country | US
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Telephone | 517-784-9104
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Fax | 517-784-9107
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Provider Business Mailing Address
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Address Line | 720 W FRANKLIN ST SUITE 1
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City | JACKSON
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State | MI
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Zip | 49201-1674
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Country | US
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Telephone | 517-784-9104
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Fax | 517-784-9107
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Authorized Official
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Title or Position | OWNER
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Name | DR. NASEER HUMAYUN
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Credential | M.D.38
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Telephone | 517-784-9104
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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 | NH033036
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License Number State | MI
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