Great Lakes Pediatric Gi Clinic PLLC

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Legal business name

GREAT LAKES PEDIATRIC GI CLINIC PLLC

Practice address

31000 Telegraph Rd Ste 100
Bingham Farms, MI 48025-4321

Phone

(248) 854-5309

NPI assigned

Mar 29, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jamal Kriem, MD

Title

Owner/Authorized Official

Phone

(248) 854-5309

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1023758257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD STE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254321",
            "telephone_number": "248-854-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD STE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254321",
            "telephone_number": "248-854-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PEDIATRIC GI CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "KRIEM",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "248-854-5309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherita Denise Grant
• Christina Grawburg
• Dianna Gray
• Marcus Lamar Grayson
• Great Lake Home Care L L C
• Dionna M Green
• Ruphene Green
• Maia Olivia Greenway
• Devin Greer-Travis
• Clarisia Greer

• Pediatric Gastroenterology Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Pediatric Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.