Individual
MS. CAN PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8040
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013653
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MI
Other
Enumeration date
12/05/2024
Last updated
02/09/2026
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