Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301109363 | MI |
Y | 2080P0202X | Pediatric Cardiologist | 4301109363 | MI |
N | 2080P0202X | Pediatric Cardiologist | A119895 | CA |
NPI | 1205077138 |
---|---|
Provider Name | Dr. David Ming-Shen Peng |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 02/08/2016 |