WATERFORD PEDIATRICS (NPI# 1104082148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104082148 |
| Entity Type | Organization |
| Organization Name | WATERFORD PEDIATRICS |
| Practice Address |
4185 Highland Rd Waterford MI 48328 |
| Practice Telephone | 2486488930 |
| Practice Fax Number | 2486488931 |
| Mailing Telephone | 2486488930 |
| Mailing Fax Number | 2486488931 |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | MRS. VICKI L INMAN (BILLING MGR) |
| Authorized Official Telephone | 2486664266 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MK057394 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MIDWEST | 021121 | 01 | |
| HEALTH PLAN | 15486 | 01 | |
| CARECHOICES | 120911 | 01 | |
| MI | 4149524 | 05 | |
| MCARE | C7543 | 01 | |
| BCBS | 0634011 | 01 |
| Street Address |
4185 HIGHLAND RD |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366759573 | Sunrise Geriatric Physicians, Pllc | General Practice | 2507 Woodbourne Dr, Waterford, MI 48329-2475 | 2010-09-09 |
| 1205908100 | Benjamin Leslie Hammack | General Practice | 3788 Old Highway Seven South, Waterford, MS 38685-0098 | 2006-11-15 |
| 1790730497 | Wally S Mahar | General Practice | 7795 Elizabeth Lake Rd, Waterford, MI 48327-3603 | 2006-05-23 |
| 1588664684 | Don Michael Endress | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2005-07-29 |
| 1326106501 | Don Michael Endress M.d. | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649120 | Source Medical Solutions Pllc | General Practice | 625 Kenmoor Ave Se Ste 301, Grand Rapids, MI 49546-2395 | 2020-11-06 |
| 1043832801 | Ksk Medical Pllc | General Practice | 6300 Winter Rd, Manitou Beach, MI 49253-9634 | 2020-05-14 |
| 1275184921 | Home Physicians Group Inc | General Practice | 18481 W 10 Mile Rd Ste 102, Southfield, MI 48075-2621 | 2019-09-24 |
| 1558913251 | Baybrooke Counseling | General Practice | 421 St. Josephs Ave, Suttons Bay, MI 49682 | 2019-07-12 |
| 1962062539 | Healthcare Alliance Pllc | General Practice | 35 S Johnson St Ste 1b, Pontiac, MI 48341-1660 | 2019-06-17 |
| 1356905061 | Comprehensive Care Medical Services | General Practice | 1747 Andover Ln Se, East Grand Rapids, MI 49506-4805 | 2019-04-29 |
| 1336602812 | Mk Certified, LLC | General Practice | 2140 Stone Rd, Ann Arbor, MI 48105-2535 | 2019-04-10 |
| 1215422555 | The Natural Momma Me Initiative | General Practice | 11000 W Mcnichols Rd Ste 212, Detroit, MI 48221-2389 | 2018-06-28 |
| 1881183028 | Silverstone Medical Group, Pllc | General Practice | 805 Oakwood Dr Ste 111, Rochester, MI 48307-1359 | 2018-05-03 |
| 1245739903 | Breanna Lee Brookens | General Practice | 1531 Barnard St, Saginaw, MI 48602-4902 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.