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Organization
GREAT LAKES PEDIATRICS
Active
Organization
GREAT LAKES PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNDUS RUMMANI-ASKAR M.D. (PRESIDENT)
(586) 427-1351
Entity
Organization
Contact information
Practice address
26000 HOOVER RD, 103, WARREN, MI 48089-1167
(586) 427-1351
Mailing address
26000 HOOVER RD, 103, WARREN, MI 48089-1167
(586) 427-1351
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301073962
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4435267
—
MI
Enumeration date
02/21/2008
Last updated
02/21/2008
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