Individual
JAMES LEE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-6509
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1860
(706) 653-1162
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301064032
MI
2085R0202X
Diagnostic Radiology Physician
52290
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942216445
—
MI
01
—
310E011330
BCBS OF MI GROUP PIN
MI
01
—
CI8050
MEDICARE RR GROUP PIN/PALMETTO GBA
MI
Enumeration date
08/01/2006
Last updated
11/18/2022
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