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Organization

SHELBY PEDIATRIC ASSOCIATES AND CHILD LUNG CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA PELLERITO (OFFICE MANAGER)
(586) 532-0599
Entity
Organization

Contact information

Practice address
15125 22 MILE RD, SHELBY TOWNSHIP, MI 48315-4406
(586) 532-0599
(586) 566-8967
Mailing address
15125 22 MILE RD, SHELBY TOWNSHIP, MI 48315-4406
(586) 532-0599
(586) 566-8967

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
AR2460549
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4432864
MI
05
4432882
MI
05
4669589
MI
Enumeration date
07/07/2006
Last updated
03/27/2024
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