Provider Demographics
NPI:1003821661
Name:PEDIATRIC CONSULTANTS OF TROY, P.C.
Entity Type:Organization
Organization Name:PEDIATRIC CONSULTANTS OF TROY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUBINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-879-6749
Mailing Address - Street 1:633 SOUTH BLVD E STE 2400
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5471
Mailing Address - Country:US
Mailing Address - Phone:248-879-5570
Mailing Address - Fax:248-879-2235
Practice Address - Street 1:633 SOUTH BLVD E STE 2400
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5471
Practice Address - Country:US
Practice Address - Phone:248-879-5570
Practice Address - Fax:248-879-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty