Provider Demographics
NPI:1912578378
Name:PELEMAN, NATALIE MARY
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARY
Last Name:PELEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2637
Mailing Address - Country:US
Mailing Address - Phone:586-651-1702
Mailing Address - Fax:
Practice Address - Street 1:37555 GARFIELD RD STE 125
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3660
Practice Address - Country:US
Practice Address - Phone:586-263-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant