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General NPI Number Information
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NPI Number | 1356508840
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Entity Type | Organization
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Legal Business Name | TROY PEDIATRICS
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 1380 COOLIDGE HWY SUITE 110
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City | TROY
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State | MI
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Zip | 48084-7069
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Country | US
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Telephone | 248-435-9310
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Fax | 248-435-9360
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Provider Business Mailing Address
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Address Line | PO BOX 745
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City | TROY
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State | MI
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Zip | 48099-0745
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Country | US
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Telephone | 248-435-9310
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Fax | 248-435-9360
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEDA SAKER
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Credential | M.D.
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Telephone | 248-435-9310
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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 | 4301071001
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License Number State | MI
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