Individual
DR. DARAVATEY DARAVUTH PEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
5450 FORT ST, TRENTON, MI 48183-4601
(734) 671-3297
Mailing address
165 N ROOSEVELT ST APT 103, CANTON, MI 48187-4893
(843) 503-0458
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5951001467
MI
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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