Individual
EDWARD M PERES
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
Mailing address
1 FORD PL, 2E, DETROIT, MI 48202-3450
(313) 874-4806
(313) 874-4677
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301071038
MI
208000000X
Pediatrics Physician
4301071038
MI
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
4301071038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4941691
—
MI
Enumeration date
06/02/2006
Last updated
01/23/2014
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