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General NPI Number Information
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NPI Number | 1588907299
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Entity Type | Individual
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Provider Name | MANAL PERACHA-RIYAZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 725 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-2936
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Country | US
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Telephone | 734-242-2727
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Fax | 734-242-2745
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Provider Business Mailing Address
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Address Line | 725 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-2936
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Country | US
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Telephone | 734-242-2727
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Fax | 734-242-2745
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D0086473
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD046531
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301103242
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License Number State | MI
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