DR. MD Michael R Petersen, NPI 1629005160
Retina Specialist (Ophthalmology) Physician in Ypsilanti, MI, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1629005160 |
| NPI Entity Type | Individual |
| Provider Name | DR. MD Michael R Petersen |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 2000 N Huron River Dr Ste 100, Ypsilanti, MI, US |
| Provider Mailing Address | 39650 Orchard Hill Pl Ste 200, Novi, MI, US, 483755391 |
| Gender | Male |
| Is Sole Proprietor? | No |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Retina Specialist (Ophthalmology) Physician |
| Classification | |
| Group | |
| License No. | 4301406847 |
| License State | MI |
| Description | An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 35-06-3107 | OH | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 180026057 | OH | RAIL ROAD MEDICARE | 01 |
| 100374400 | IN | MEDICAID | 05 |
| 000000021228 | BCBS | 01 | |
| 0886528 | OH | MEDICAID | 05 |
| 64930167 | KY | MEDICAID | 05 |
Health Information Exchange
| Endpoint Type | Endpoint | Description | Use | Content Type | Affiliation | Location |
|---|---|---|---|---|---|---|
| DIRECT | [email protected] | No | 2000 N Huron River Dr Ste 100, Ypsilanti, MI, US |
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