Provider Demographics
NPI:1699285023
Name:CAMPGROUND PEDIATRICS WELLNESS CENTER
Entity type:Organization
Organization Name:CAMPGROUND PEDIATRICS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FILIPOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-212-3113
Mailing Address - Street 1:51474 ORO DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60005 CAMPGROUND RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48094-3445
Practice Address - Country:US
Practice Address - Phone:586-991-7683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty