Individual provider Active NPI

Sydney Marie Peters, MD

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1104755628
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351055606 Issued in MI
Practice address
400 E Eisenhower Pkwy Ste B
Ann Arbor, MI 48108-3302
Phone
(734) 539-5080
NPI assigned
May 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351055606 MI Primary

Addresses

Primary practice location

400 E Eisenhower Pkwy Ste B
Ann Arbor, MI 48108-3302

Mailing address

1200 E Hospital Dr. D3230
Ann Arbor, MI 48109
Phone (734) 647-1774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351055606MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1104755628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E HOSPITAL DR. D3230",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-647-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EISENHOWER PKWY STE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083302",
            "telephone_number": "734-539-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "SYDNEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351055606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.