Provider Demographics
NPI:1538151436
Name:PIERRET, GUY (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:
Last Name:PIERRET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29900 LORRAINE AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-5266
Mailing Address - Country:US
Mailing Address - Phone:586-582-0864
Mailing Address - Fax:586-582-0964
Practice Address - Street 1:11012 E 13 MILE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2572
Practice Address - Country:US
Practice Address - Phone:586-573-6880
Practice Address - Fax:586-573-2562
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301032679207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1273960Medicaid
MIGP032679OtherBCBS PIN #
MI1273960Medicaid
B44015Medicare UPIN