Provider Demographics
NPI:1346239647
Name:PEDIATRIC PARTNERS PLC
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:KELLEY
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-656-8600
Mailing Address - Street 1:4600 BRETON RD SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5262
Mailing Address - Country:US
Mailing Address - Phone:616-656-8600
Mailing Address - Fax:616-656-8601
Practice Address - Street 1:4600 BRETON RD SE
Practice Address - Street 2:SUITE 103
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-5262
Practice Address - Country:US
Practice Address - Phone:616-656-8600
Practice Address - Fax:616-656-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty