Organization
SHORELINE PEDIATRICS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEANNE KOLENDA (PRACTICE MANAGER)
(231) 773-7837
Entity
Organization
Contact information
Practice address
684 HARVEY ST, SUITE 201, MUSKEGON, MI 49442-4274
(231) 773-7837
(231) 773-7943
Mailing address
2680 VULCAN ST, NORTON SHORES, MI 49444-2344
(231) 773-7837
(231) 773-7943
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500F113130
BCBS MICHIGAN
MI
Enumeration date
07/13/2005
Last updated
04/14/2023
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