Individual
ANGEL ROLANDO PERALTA-AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
(313) 876-1305
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(800) 653-6568
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2010020280
MO
207R00000X
Internal Medicine Physician
C175635
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301113201
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C175635
CA
207RP1001X
Pulmonary Disease Physician
4301113201
MI
207RP1001X
Pulmonary Disease Physician
C175635
CA
Other
Enumeration date
08/20/2010
Last updated
07/25/2025
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