Provider Demographics
NPI:1396747572
Name:PEERY, DEBORAH LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:PEERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:208 W BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1105
Mailing Address - Country:US
Mailing Address - Phone:734-429-9377
Mailing Address - Fax:734-429-8277
Practice Address - Street 1:208 W BENNETT ST
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1105
Practice Address - Country:US
Practice Address - Phone:734-429-9377
Practice Address - Fax:734-429-8277
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDP048839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382742669OtherCIGNA HEALTH PLANS
MI382742669OtherPRIORITY HEALTH
MI027980OtherMIDWEST HEALTH PLAN
MI382742669OtherUNITED HEALTHCARE PLANS
MI382742669OtherWASHTENAW HEALTH PLAN
MI0N14060OtherMICHIGAN MEDICARE PLUS BL
MI382742669OtherCOFINITY
MIA74234OtherHEALTH ALLIANCE PLAN HMO
MI0813416OtherBLUE CARE NETWORK OF MICH
MI1108134161OtherBCBS OF MICHIGAN PIN
MI382742669OtherMICHIGAN TAX ID
MIDP048839OtherMICHIGAN STATE LICENSE
MI101812233Medicaid
MIA5035098OtherAETNA PLANS
MIA74234OtherHEALTH ALLIANCE PLAN HMO
MIDP048839OtherMICHIGAN STATE LICENSE