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General NPI Number Information
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NPI Number | 1801010681
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Entity Type | Organization
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Legal Business Name | BELLEVILLE PEDIATRICS
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 8449 PARK AVE STE 2
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City | ALLEN PARK
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State | MI
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Zip | 48101-1788
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Country | US
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Telephone | 313-386-1100
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Fax | 313-735-2403
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Provider Business Mailing Address
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Address Line | 8449 PARK AVE STE 2
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City | ALLEN PARK
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State | MI
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Zip | 48101-1788
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Country | US
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Telephone | 133-861-1003
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Fax | 734-697-1948
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Authorized Official
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Title or Position | CEO
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Name | MUHAMMAD A AL-ADO
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Credential | MD
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Telephone | 734-697-2595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301066704
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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