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Organization

PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN R LULL MD (PRESIDENT)
(269) 327-1900
Entity
Organization

Contact information

Practice address
670 MALL DR, PORTAGE, MI 49024-2878
(269) 327-1900
(269) 327-1564
Mailing address
670 MALL DR, PORTAGE, MI 49024-2878
(269) 327-1900
(269) 327-1564

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
10/14/2005
Last updated
08/22/2020
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