Individual
PETER DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26025 LAHSER RD, 2ND FLOOR, SOUTHFIELD, MI 48033-2601
(248) 663-1900
(248) 663-1902
Mailing address
26211 CENTRAL PARK BLVD STE 201, SOUTHFIELD, MI 48076-4158
(833) 667-3627
(833) 972-5509
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301085729
MI
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
4301085729
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0767220001
ADMINISTAR FEDERAL
MI
01
—
0F31114
BCBS
MI
01
—
0F33583
BCBS DME
MI
05
—
4873214
—
MI
01
—
MI10377060
CMS
—
Enumeration date
07/10/2006
Last updated
04/27/2026
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