Organization
GRAND BLANC PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAWAZ HADDAD M.D. (OWNER)
(810) 695-6565
Entity
Organization
Contact information
Practice address
8220 S SAGINAW ST, SUITE 1000, GRAND BLANC, MI 48439-1890
(810) 695-6565
(810) 695-9476
Mailing address
8220 S SAGINAW ST, SUITE 1000, GRAND BLANC, MI 48439-1890
(810) 695-6565
(810) 695-9476
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
FH063791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4675100
—
MI
Enumeration date
04/10/2007
Last updated
08/22/2020
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