Provider Demographics
NPI:1881381945
Name:PERUSKI, VICTORIA ROSE (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSE
Last Name:PERUSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ROSE
Other - Last Name:PERUSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:24035 TIMBER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-8013
Mailing Address - Country:US
Mailing Address - Phone:734-493-2288
Mailing Address - Fax:
Practice Address - Street 1:CAMC BEHAVIORAL MEDICINE & PSYCHIATRY
Practice Address - Street 2:3200 MACCORKLE AVE SE
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-388-1000
Practice Address - Fax:304-388-1041
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program