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General NPI Number Information
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NPI Number | 1699285023
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Entity Type | Organization
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Legal Business Name | CAMPGROUND PEDIATRICS WELLNESS CENTER
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 60005 CAMPGROUND RD
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City | WASHINGTON TOWNSHIP
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State | MI
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Zip | 48094-3445
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Country | US
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Telephone | 586-991-7683
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Fax |
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Provider Business Mailing Address
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Address Line | 51474 ORO DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CINZIA FILIPOVSKI
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Credential |
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Telephone | 586-212-3113
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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 |
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License Number State |
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