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General NPI Number Information
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NPI Number | 1720493364
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Entity Type | Organization
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Legal Business Name | THE PEDIATRIC TEAM
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 909 W MAPLE RD SUITE 111
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City | CLAWSON
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State | MI
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Zip | 48017-1000
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Country | US
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Telephone | 248-288-5437
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Fax | 248-288-5449
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Provider Business Mailing Address
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Address Line | 909 W MAPLE RD SUITE 111
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City | CLAWSON
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State | MI
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Zip | 48017-1000
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Country | US
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Telephone | 248-288-5437
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Fax | 248-288-5449
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. PETER T MULLER
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Credential | MD
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Telephone | 248-288-5437
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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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