Organization
PROMEDICA CENTRAL PHYSICIANS LLC
Active
Organization
PROMEDICA CENTRAL PHYSICIANS LLC
Active
Other names
ProMedica Children's Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN KNUEVEN (CREDENTIALING SUPERVISOR)
(567) 585-1969
Entity
Organization
Contact information
Practice address
730 N MACOMB ST, SUITE 300, MONROE, MI 48162-2900
(419) 291-7010
(419) 479-6917
Mailing address
730 N MACOMB ST, SUITE 300, MONROE, MI 48162-2900
(419) 291-7010
(419) 479-6917
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
MI
Other
Enumeration date
12/11/2012
Last updated
02/05/2021
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