Individual
DONALD R PEVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44405 WOODWARD AVE, ST JOSEPH MERCY HOSPITAL, PONTIAC, MI 48341-2985
(248) 858-3190
(248) 858-3148
Mailing address
PO BOX 55-114, DETROIT, MI 48255
(248) 858-3190
(248) 858-3148
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
048568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4357705
—
MI
Enumeration date
07/03/2006
Last updated
07/19/2007
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