Individual
DR. JACK W PEARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9398 N LILLEY RD, PLYMOUTH, MI 48170-4610
(734) 459-2255
(734) 459-1855
Mailing address
9398 N LILLEY RD, PLYMOUTH, MI 48170-4610
(734) 459-2255
(734) 459-1855
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
5101004511
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2628611
—
MI
Enumeration date
05/03/2006
Last updated
01/14/2010
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