Healthcare Provider Details

I. General information

NPI: 1922286061
Provider Name (Legal Business Name): DR. STEVEN M. PEARL MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35550 CENTRAL CITY PKWY
WESTLAND MI
48185
US

IV. Provider business mailing address

30730 FORD RD
GARDEN CITY MI
48135-1803
US

V. Phone/Fax

Practice location:
  • Phone: 734-762-9935
  • Fax: 734-762-5006
Mailing address:
  • Phone: 734-421-7362
  • Fax: 734-421-5219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number4301054222
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301054222
License Number StateMI

VIII. Authorized Official

Name: DR. STEVEN M PEARL
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 734-762-9935