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Individual

DR. PETER VERGOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3385 S CENTER RD, BURTON, MI 48519-1457
(810) 244-3434
(810) 715-0301
Mailing address
3385 S CENTER RD, BURTON, MI 48519-1457
(810) 244-3434
(810) 715-0301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003310
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1093470001
MCSUPPLY
MI
01
900B56331
BC NETWORK
MI
01
900B567090
BCBS
MI
01
PV003310
BCVISION
MI
Enumeration date
02/02/2006
Last updated
05/11/2011
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