Organization
HALO PEDIATRICS
Active
Parent organization
HALO MEDICAL GROUP PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HALO MEDICAL GROUP PLLC
Authorized official
HANADY BEYDOUN (OFFICE MANAGER)
(313) 993-7777
Entity
Organization
Contact information
Practice address
17600 W WARREN AVE, DETROIT, MI 48228-3509
(313) 450-4411
Mailing address
22720 MICHIGAN AVE STE 200, DEARBORN, MI 48124-2021
(313) 450-4411
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13511211
CAQH
—
Enumeration date
02/27/2019
Last updated
02/27/2019
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