Organization
GREAT LAKES PEDIATRIC GI CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMAL KRIEM MD (OWNER/AUTHORIZED OFFICIAL)
(248) 854-5309
Entity
Organization
Contact information
Practice address
31000 TELEGRAPH RD STE 100, BINGHAM FARMS, MI 48025-4321
(248) 854-5309
Mailing address
31000 TELEGRAPH RD STE 100, BINGHAM FARMS, MI 48025-4321
(248) 854-5309
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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