Organization
MUSKEGON PEDIATRICS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MARIE KING MD (OWNER, PHYSICIAN)
(517) 294-8741
Entity
Organization
Contact information
Practice address
888 TERRACE ST, MUSKEGON, MI 49440-1220
(517) 294-8741
Mailing address
16703 POND CRK, SPRING LAKE, MI 49456-9792
(517) 294-8741
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558591073
NPI
MI
01
—
5315053660
STATE LICENSE
MI
01
—
802429468
CORPORATION LICENSING
MI
Enumeration date
03/17/2020
Last updated
03/17/2020
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