Provider Demographics
NPI:1356508840
Name:TROY PEDIATRICS
Entity Type:Organization
Organization Name:TROY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-435-9310
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-0745
Mailing Address - Country:US
Mailing Address - Phone:248-435-9310
Mailing Address - Fax:248-435-9360
Practice Address - Street 1:1380 COOLIDGE HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7069
Practice Address - Country:US
Practice Address - Phone:248-435-9310
Practice Address - Fax:248-435-9360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071001208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty