Pediatrics PC

NPI #1265421069 in Portage, Michigan

Provider Information

NPI Number: 1265421069
Entity Type: Organization
Organization Name: Pediatrics PC
Primary Specialty: Pediatrics
Enumeration Date: Oct 14, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 670 MALL DR
City: Portage
State: Michigan
ZIP Code: 49024-2878
Phone: (269) 327-1900

Authorized Official

Name: STEPHEN R LULL, MD
Title: PRESIDENT
Phone: (269) 327-1900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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