Individual
PETER MARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
930 JOHN R RD APT 2129, TROY, MI 48083-4318
(248) 990-5314
(586) 983-9604
Mailing address
42017 DUXBURY DR, STERLING HEIGHTS, MI 48313-3473
(248) 990-5314
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87200835
—
MI
Enumeration date
09/17/2017
Last updated
06/16/2018
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