Basic Information
| Provider Information | |||||||||
| NPI: | 1396747572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEERY | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 W BENNETT ST | ||||||||
| Address2: | |||||||||
| City: | SALINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481761105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344299377 | ||||||||
| FaxNumber: | 7344298277 | ||||||||
| Practice Location | |||||||||
| Address1: | 208 W BENNETT ST | ||||||||
| Address2: | |||||||||
| City: | SALINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481761105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344299377 | ||||||||
| FaxNumber: | 7344298277 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 09/08/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DP048839 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 382742669 | 01 | MI | CIGNA HEALTH PLANS | OTHER | 382742669 | 01 | MI | PRIORITY HEALTH | OTHER | 027980 | 01 | MI | MIDWEST HEALTH PLAN | OTHER | 382742669 | 01 | MI | UNITED HEALTHCARE PLANS | OTHER | 382742669 | 01 | MI | WASHTENAW HEALTH PLAN | OTHER | 0N14060 | 01 | MI | MICHIGAN MEDICARE PLUS BL | OTHER | 382742669 | 01 | MI | COFINITY | OTHER | A74234 | 01 | MI | HEALTH ALLIANCE PLAN HMO | OTHER | 0813416 | 01 | MI | BLUE CARE NETWORK OF MICH | OTHER | 1108134161 | 01 | MI | BCBS OF MICHIGAN PIN | OTHER | 382742669 | 01 | MI | MICHIGAN TAX ID | OTHER | DP048839 | 01 | MI | MICHIGAN STATE LICENSE | OTHER | 101812233 | 05 | MI | MEDICAID | A5035098 | 01 | MI | AETNA PLANS | OTHER |