Dr. Elliot Carr Pennington
Pediatric Surgery
330 Barclay Ave Ne Ste 202
Grand Rapids
, Michigan 49503-2525
Dr. Elliot Carr Pennington
Pediatric Surgery
330 Barclay Ave Ne Ste 202
Grand Rapids
, Michigan 49503-2525
(616) 458-0061
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Dr. Elliot Carr Pennington
- 330 Barclay Ave Ne Ste 202
- Grand Rapids, MI
- Zip : 49503-2525
- Fax : (616) 458-0061
- Phone : (616) 458-1722
Second Address
- Dr. Elliot Carr Pennington
- 330 Barclay Ave Ne Ste 202
- Grand Rapids, MI
- Zip : 49503-2525
- Fax : (616) 458-0061
- Phone : (616) 458-1722
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 1235365081 | MI |
National Provider Identifier
| NPI | 1235365081 |
|---|---|
| Provider Name | Dr. Elliot Carr Pennington |
| First Address | Grand Rapids, MI 49503-2525 |
| Second Address | Grand Rapids, MI 49503-2525 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/06/2009 |
| Last Update Date | 13/08/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.