Individual
DIEGO ALFONSO PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
15760 19 MILE RD STE E, CLINTON TOWNSHIP, MI 48038-6319
(586) 329-3895
Mailing address
18309 PIERRE DR, CLINTON TOWNSHIP, MI 48038-1254
(614) 931-1856
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901400567
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2022
Last updated
06/20/2025
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