Provider Demographics
NPI:1013959345
Name:ALITA RICE MD PC
Entity Type:Organization
Organization Name:ALITA RICE MD PC
Other - Org Name:THE PEDIATRIC PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-476-1788
Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:DEPT 253201
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-2532
Mailing Address - Country:US
Mailing Address - Phone:248-476-1788
Mailing Address - Fax:248-476-1753
Practice Address - Street 1:19840 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2048
Practice Address - Country:US
Practice Address - Phone:248-476-1788
Practice Address - Fax:248-476-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053820208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI105147OtherCARE CHOICES
MI5097520OtherAETNA
MI4240023Medicaid
MIC5880OtherMCARE
MI3508288582OtherBCBC BCN
MIF64874OtherHAP
MI5097520OtherAETNA
MI0N17370Medicare PIN