Provider Demographics
NPI:1386135077
Name:PEREZ, CATHERINE ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 CATHERINE STREET
Mailing Address - Street 2:5231E MED SCI I
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5602
Mailing Address - Country:US
Mailing Address - Phone:734-764-3270
Mailing Address - Fax:734-615-2964
Practice Address - Street 1:1301 CATHERINE STREET
Practice Address - Street 2:5231E MED SCI I
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5602
Practice Address - Country:US
Practice Address - Phone:734-764-3270
Practice Address - Fax:734-615-2964
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301115228390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program