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NPI Code Detail

MEDICARE: JOEL L PELAVIN M.D.,P.C.

MEDICARE: JOEL L PELAVIN M.D.,P.C.
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
1207W00000XOphthalmology PhysicianJP042865MI

General Provider Information

NPI Number : 1881654655
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL L PELAVIN M.D.,P.C.
Provider Business Mailing Address
First Line : 29750 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-2607
Country : US
Telephone Number : 586-296-7770
Fax Number : 586-296-9617
Provider Business Practice Location Address
First Line : 29750 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-2607
Country : US
Telephone Number : 586-296-7770
Fax Number : 586-296-9617
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 04/18/2014

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