Provider Demographics
NPI:1629094172
Name:ROYAL OAK PEDIATRICS PC
Entity Type:Organization
Organization Name:ROYAL OAK PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LALIT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-398-8400
Mailing Address - Street 1:26657 WOODWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1371
Mailing Address - Country:US
Mailing Address - Phone:248-398-8400
Mailing Address - Fax:248-398-8487
Practice Address - Street 1:26657 WOODWARD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1371
Practice Address - Country:US
Practice Address - Phone:248-398-8400
Practice Address - Fax:248-398-8487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty