Individual provider · NPI-1

Samuel Marcus Perez, BA

Specialist/Technologist, Other · Southgate, MI

NPI number1992397947
StatusActive
Last updated in NPPESFeb 10, 2021

Details

NPI
1992397947
Entity type
Individual (NPI-1)
Name
Mr. Samuel Marcus Perez
Credential
BA
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 10, 2021
Certification date
Feb 9, 2021
Last updated
Feb 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other––Yes

Practice location

13101 Allen Rd
Southgate, MI 48195-2216

Phone 734-785-7700

Mailing address

13101 Allen Rd
Southgate, MI 48195-2216

Phone 734-785-7700

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