Juan Manuel Perez, M.D.

Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Southfield, MI

NPI 1760445878 · NPPES record last updated Jan 20, 2012

Key facts

NPI
1760445878
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
License
5315028244 (MI)
Practice address
24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501
Phone
(248) 799-0086
Fax
(248) 350-1178
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5315028244MIMDGeriatric Medicine (Internal Medicine) Physician
4696PRMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthland Housecall Services LLC Geriatric Medicine Past
since Dec 9, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4696 PR
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 5315028244 MI Yes

Addresses

Primary practice location

24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501

Mailing address

24445 Northwestern Hwy
Suite 206
Southfield, MI 48075-6501
Phone (248) 799-0086

Other names

  • Dr. Juan Manuel Perez Mendez Former name

Other providers in Southfield, MI

All providers in Southfield, MI · Geriatric Medicine (Internal Medicine) Physician in Michigan

Sources for this page

Verify at the official NPI Registry.