Individual
DR. STEPHEN L PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 SHAFFER ST, SUITE 232, KALAMAZOO, MI 49048-1647
(269) 226-5050
(269) 226-5034
Mailing address
1717 SHAFFER ST, SUITE 232, KALAMAZOO, MI 49048-1647
(269) 226-5050
(269) 226-5034
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301038298
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301038298
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1394115
—
MI
01
—
25-31067
PHP/IBA
MI
01
—
P54643
BCN
ME
01
—
SP038298
BCBS
MI
Enumeration date
09/22/2006
Last updated
06/11/2015
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