Provider Demographics
NPI:1205014529
Name:PETER M. TORRICE DPM PC
Entity Type:Organization
Organization Name:PETER M. TORRICE DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM PC
Authorized Official - Phone:586-779-8600
Mailing Address - Street 1:20967 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3128
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:48021-3128
Practice Address - Country:US
Practice Address - Phone:586-779-8600
Practice Address - Fax:586-779-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPT000613213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1036939Medicaid
T34076Medicare UPIN
MI0677920001Medicare NSC
MI5505819Medicare PIN