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NPI Code Detail

MEDICARE: BRYAN M PEREIRA M.D.

MEDICARE: BRYAN M PEREIRA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207T00000XNeurological Surgery PhysicianA-70278CA
2207T00000XNeurological Surgery PhysicianDR.0054621CO
3207T00000XNeurological Surgery Physician4301087004MI

General Provider Information

NPI Number : 1154391589
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN M PEREIRA M.D.
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 313-874-4806
Fax Number :
Provider Business Practice Location Address
First Line : 1201 E MICHIGAN AVE STE 240
Second Line :
City : JACKSON
State : MI
Zip : 49201-1855
Country : US
Telephone Number : 517-205-1591
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 07/18/2023

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Directions to “ BRYAN M PEREIRA M.D.” Practice Location

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