Healthcare Provider Details

I. General information

NPI: 1972448751
Provider Name (Legal Business Name): PEYTON ALEXIS ERNDTEMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14700 E OLD US HIGHWAY 12
CHELSEA MI
48118-1185
US

IV. Provider business mailing address

300 N INGALLS ST # NI4C06
ANN ARBOR MI
48109-0400
US

V. Phone/Fax

Practice location:
  • Phone: 734-539-5000
  • Fax:
Mailing address:
  • Phone: 734-615-2690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: