Organization
LIVONIA DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PEGOUSKE M.D. (OWNER)
(734) 542-8100
Entity
Organization
Contact information
Practice address
14801 FARMINGTON RD, LIVONIA, MI 48154-5429
(734) 542-8100
(734) 542-8168
Mailing address
14801 FARMINGTON RD, LIVONIA, MI 48154-5429
(734) 542-8100
(734) 542-8168
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
12/06/2011
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