Provider Demographics
NPI:1942903810
Name:SAGINAW VALLEY PEDIATRICS PLLC
Entity Type:Organization
Organization Name:SAGINAW VALLEY PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-797-1061
Mailing Address - Street 1:5821 COLONY DR N
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5716
Mailing Address - Country:US
Mailing Address - Phone:989-797-1051
Mailing Address - Fax:989-799-0256
Practice Address - Street 1:5821 COLONY DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5716
Practice Address - Country:US
Practice Address - Phone:989-797-1051
Practice Address - Fax:989-799-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty