Provider Demographics
NPI:1992782213
Name:TORRICE, PETER MICHAEL (DPM PC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:MICHAEL
Last Name:TORRICE
Suffix:
Gender:M
Credentials:DPM PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20967 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021
Mailing Address - Country:US
Mailing Address - Phone:586-779-8600
Mailing Address - Fax:586-779-2019
Practice Address - Street 1:20967 KELLY RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021
Practice Address - Country:US
Practice Address - Phone:586-779-8600
Practice Address - Fax:586-779-2019
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPT000613213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1036939Medicaid
MI1036939Medicaid
MI0677920001Medicare NSC
MI5505819Medicare PIN