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General NPI Number Information
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NPI Number | 1508306093
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Entity Type | Organization
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Legal Business Name | ROCKFORD PEDIATRICS
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 6116 NORTHLAND DR NE
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City | ROCKFORD
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State | MI
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Zip | 49341
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Country | US
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Telephone | 616-259-6100
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Fax | 616-259-5730
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Provider Business Mailing Address
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Address Line | 6116 NORTHLAND DR NE
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City | ROCKFORD
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State | MI
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Zip | 49341
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Country | US
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Telephone | 616-259-6100
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Fax | 616-259-5730
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Authorized Official
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Title or Position | OWNER
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Name | TREW J STRANSKY
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Credential | DO
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Telephone | 616-259-6100
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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 | 5101015010
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License Number State | MI
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