Provider Demographics
NPI:1801017165
Name:DOCTORS FOR KIDS, PLC
Entity Type:Organization
Organization Name:DOCTORS FOR KIDS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-650-5009
Mailing Address - Street 1:101 ROCHDALE DR S
Mailing Address - Street 2:STE B
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2273
Mailing Address - Country:US
Mailing Address - Phone:248-650-5009
Mailing Address - Fax:248-652-9557
Practice Address - Street 1:101 ROCHDALE DR S
Practice Address - Street 2:STE B
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2273
Practice Address - Country:US
Practice Address - Phone:248-650-5009
Practice Address - Fax:248-652-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH60339Medicare UPIN