Provider Demographics
NPI:1215093216
Name:ALGER PEDIATRICS PC
Entity type:Organization
Organization Name:ALGER PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:DAINING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-243-9515
Mailing Address - Street 1:733 ALGER ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3530
Mailing Address - Country:US
Mailing Address - Phone:616-243-9515
Mailing Address - Fax:616-243-1815
Practice Address - Street 1:733 ALGER ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3530
Practice Address - Country:US
Practice Address - Phone:616-243-9515
Practice Address - Fax:616-243-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI042824208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty