Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 5101008985 | MI |
N | 207QA0401X | Family Doctor - Addiction Medicine | 5101008985 | MI |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 5101008985 | MI |
NPI | 1225065063 |
---|---|
Provider Name | Peter R Schoeps |
First Address | Southfield, MI 48033-3849 |
Second Address | Farmington, MI 48336-3133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128608 | CARE CHOICES (01) | MI |
4229882 | AETNA (01) | MI |
5631016 | BLUE CROSS (01) | MI |
B2551 | MCARE (01) | MI |
E73386 | (02) | |
P45080 | BLUE CROSS (01) | MI |