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Individual

EDGARD PEDRAZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1547 S WAYNE RD, WESTLAND, MI 48186-5436
(734) 405-0176
(586) 795-5540
Mailing address
5528 METRO PKWY, STERLING HEIGHTS, MI 48310-4105
(586) 795-3232
(586) 795-5540

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301034895
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0N15280
MEDICARE GROUP ID FOR APEX BEHAVIORAL HEALTH
MI
01
0N15280004
MEDICARE PIN LINKED TO APEX BEHAVIORAL HEALTH
MI
05
4308952 10
MI
05
4767490
MI
Enumeration date
09/28/2007
Last updated
07/03/2008
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