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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