Provider Demographics
NPI:1255564407
Name:PREFERRED MEDICAL PROFESSIONALS, P.C.
Entity type:Organization
Organization Name:PREFERRED MEDICAL PROFESSIONALS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-564-8930
Mailing Address - Street 1:211 GLENDALE ST
Mailing Address - Street 2:SUITE 323
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3231
Mailing Address - Country:US
Mailing Address - Phone:313-564-8930
Mailing Address - Fax:313-564-8933
Practice Address - Street 1:211 GLENDALE ST
Practice Address - Street 2:SUITE 323
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3231
Practice Address - Country:US
Practice Address - Phone:313-564-8930
Practice Address - Fax:313-564-8933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty