Individual
BRIAN ALEXANDER PESHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 ABBOT RD STE 400, EAST LANSING, MI 48823-1956
(517) 332-0100
(517) 332-0356
Mailing address
1500 ABBOT RD STE 400, EAST LANSING, MI 48823-1956
(517) 332-0100
(517) 332-0356
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301080097
MI
207Y00000X
Otolaryngology Physician
7733A
WY
207YX0602X
Otolaryngic Allergy Physician
7733A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952528572
—
MI
05
—
W21454
—
WY
05
—
W21458
—
WY
Enumeration date
04/18/2007
Last updated
01/26/2015
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