Provider Demographics
NPI:1134526437
Name:VINSON, PIERRE E
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:E
Last Name:VINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 WAYBURN ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1070
Mailing Address - Country:US
Mailing Address - Phone:313-451-1348
Mailing Address - Fax:
Practice Address - Street 1:200 MOUNT ELLIOTT ST STE 111
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4466
Practice Address - Country:US
Practice Address - Phone:313-451-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist