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Individual
DR. MICHAEL R PENA
Active
Individual
DR. MICHAEL R PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PHD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26460
NE
207Q00000X
Family Medicine Physician
8607
SD
207Q00000X
Family Medicine Physician
Primary
MD2017-0882
NM
207Q00000X
Family Medicine Physician
MD443240
PA
Other
Enumeration date
04/07/2011
Last updated
03/17/2018
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