Organization
PEDIATRIC LOCUM CARE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED G MOHIUDDIN MD (OWNER)
(810) 664-4531
Entity
Organization
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5000
Mailing address
PO BOX 251, LAPEER, MI 48446-0251
(810) 664-4531
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301048359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3506363151
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
02/15/2008
Last updated
04/16/2008
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