Provider Demographics
NPI:1740227743
Name:BACKOS, ALCESA ABELGAS (MD FAAP)
Entity Type:Individual
Prefix:
First Name:ALCESA
Middle Name:ABELGAS
Last Name:BACKOS
Suffix:
Gender:F
Credentials:MD FAAP
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Other - Credentials:
Mailing Address - Street 1:4201 SAINT ANTOINE ST
Mailing Address - Street 2:UHC 5D MAILBOX 226 UNIVERSITY PEDIATRICIANS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-4405
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:CHILDREN'S HOSPITAL OF MI
Practice Address - Street 2:3950 BEAUBIEN
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-832-8290
Practice Address - Fax:313-993-0081
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2017-01-13
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Provider Licenses
StateLicense IDTaxonomies
MI4301048246208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics