Organization
MIKIDS PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE GARBACIK (CREDENTIALING SPECIALIST)
(616) 235-4800
Entity
Organization
Contact information
Practice address
7150 KALAMAZOO AVE SE, SUITE A, CALEDONIA, MI 49316
(616) 818-7454
(616) 818-7455
Mailing address
7150 KALAMAZOO AVE SE, SUITE A, CALEDONIA, MI 49316-9126
(616) 818-7454
(616) 818-7455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
03/04/2019
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