Provider Demographics
NPI:1790533172
Name:MILLER, PEARSON MICHEL (OD, MS)
Entity type:Individual
Prefix:
First Name:PEARSON
Middle Name:MICHEL
Last Name:MILLER
Suffix:
Gender:
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5699 LADDERBACK
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-8689
Mailing Address - Country:US
Mailing Address - Phone:517-528-5303
Mailing Address - Fax:
Practice Address - Street 1:1622 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5924
Practice Address - Country:US
Practice Address - Phone:412-530-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005866152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program