Provider Demographics
NPI:1295836096
Name:ABC PEDIATRICS, PC
Entity Type:Organization
Organization Name:ABC PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMMER-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-458-3677
Mailing Address - Street 1:4288 THREE MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534
Mailing Address - Country:US
Mailing Address - Phone:616-458-3677
Mailing Address - Fax:616-459-6850
Practice Address - Street 1:4288 THREE MILE ROAD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534
Practice Address - Country:US
Practice Address - Phone:616-458-3677
Practice Address - Fax:616-459-6850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty