Organization
PEDIATRIC PRACTICE, INC
Active
Organization
PEDIATRIC PRACTICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOVIN BASKAR M.D. (PRESIDENT)
(216) 529-7780
Entity
Organization
Contact information
Practice address
14701 DETROIT AVE STE 730, LAKEWOOD, OH 44107-4182
(216) 529-7780
(216) 529-7432
Mailing address
14701 DETROIT AVE STE 730, LAKEWOOD, OH 44107-4182
(216) 529-7780
(216) 529-7432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2259087
—
OH
Enumeration date
05/21/2007
Last updated
03/13/2024
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