Provider Demographics
NPI:1194743898
Name:MACOMB COUNTY PEDIATRICS DBA CLINTON PREFERRED PEDIATRICS, PC
Entity type:Organization
Organization Name:MACOMB COUNTY PEDIATRICS DBA CLINTON PREFERRED PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY-TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIEGFRIED
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEIGHOFER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:586-263-6464
Mailing Address - Street 1:15500 19 MILE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6330
Mailing Address - Country:US
Mailing Address - Phone:586-263-6464
Mailing Address - Fax:586-263-8491
Practice Address - Street 1:15500 19 MILE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6330
Practice Address - Country:US
Practice Address - Phone:586-263-6464
Practice Address - Fax:586-263-8491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty