Healthcare Provider Details

I. General information

NPI: 1801839097
Provider Name (Legal Business Name): STEVEN PEARL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W UNIVERSITY DR
ROCHESTER MI
48307-1863
US

IV. Provider business mailing address

30700 TELEGRAPH RD STE 1645
BINGHAM FARMS MI
48025-4525
US

V. Phone/Fax

Practice location:
  • Phone: 248-283-1100
  • Fax: 248-283-1103
Mailing address:
  • Phone: 248-283-1100
  • Fax: 248-283-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301054222
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301054222
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: