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General NPI Number Information
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NPI Number | 1881862548
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Entity Type | Organization
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Legal Business Name | PEDIATRIC LOCUM CARE PLC
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 44201 DEQUINDRE RD
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City | TROY
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State | MI
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Zip | 48085-1117
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Country | US
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Telephone | 248-964-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 251
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City | LAPEER
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State | MI
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Zip | 48446-0251
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Country | US
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Telephone | 810-664-4531
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED G MOHIUDDIN
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Credential | MD
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Telephone | 810-664-4531
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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 | 4301048359
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License Number State | MI
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