Provider Demographics
NPI:1508849498
Name:DEWS, PETER III (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:DEWS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 COMMONWEALTH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49650 CHERRY HILL RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4849
Practice Address - Country:US
Practice Address - Phone:734-398-7800
Practice Address - Fax:734-398-7805
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301050669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE76132Medicare UPIN