Individual
MR. MIKE E. PELIVANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
4200 WISCONSIN AVE NW, WASHINGTON, DC 20016-2143
(202) 244-1308
(202) 244-2050
Mailing address
4200 WISCONSIN AVE NW, WASHINGTON, DC 20016-2143
(202) 244-1308
(202) 244-2050
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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