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Organization
PEGGY RICHARDSON-MOORE MD PC
Active
Organization
PEGGY RICHARDSON-MOORE MD PC
Active
Other names
Preferred Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEGGY RICHARDSON (MD)
(313) 564-8930
Entity
Organization
Contact information
Practice address
211 GLENDALE ST STE 200, HIGHLAND PARK, MI 48203-3231
(313) 564-8930
(313) 564-8933
Mailing address
211 GLENDALE ST STE 200, HIGHLAND PARK, MI 48203-3231
(313) 564-8930
(313) 564-8933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301041722
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5102934
—
MI
Enumeration date
04/02/2012
Last updated
04/12/2012
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