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General NPI Number Information
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NPI Number | 1174625420
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Entity Type | Organization
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Legal Business Name | ALAN P PETER DO PC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 12/28/2008
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Provider Practice Location Address
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Address Line | 16800 24 MILE RD SUITE 4
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City | MACOMB TWP
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State | MI
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Zip | 48042
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Country | US
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Telephone | 586-992-9970
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Fax | 586-992-9972
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Provider Business Mailing Address
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Address Line | 16800 24 MILE RD SUITE 4
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City | MACOMB TWP
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State | MI
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Zip | 48042
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Country | US
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Telephone | 586-992-9970
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Fax | 586-992-9972
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. ALAN P PETER
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Credential | DO
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Telephone | 586-992-9970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101014745
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License Number State | MI
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