Organization
PEDICARE PEDIATRIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNA JEAN TURKISH DO (OWNER)
(734) 427-4067
Entity
Organization
Contact information
Practice address
35240 NANKIN BLVD, STE # 401, WESTLAND, MI 48185-7218
(734) 427-3636
(734) 427-1483
Mailing address
35240 NANKIN BLVD, STE # 401, WESTLAND, MI 48185-7218
(734) 427-3636
(734) 427-1483
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
VT 006757
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3025602-11
—
MI
01
—
383159597
FEDERAL TAX ID
MI
01
—
VT 006757
LICENSE NO.
MI
Enumeration date
08/21/2006
Last updated
07/14/2008
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