Buenaventura Carmen Pereyra, M.D
Individual provider Active NPI Specialist · Wyoming, MI
NPI 1992884332 · NPPES record last updated Mar 29, 2008
Key facts
- NPI
- 1992884332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 5851 (PR)
- Practice address
- 4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519-4844 - Phone
- (646) 509-4511
- Fax
- (616) 530-2854
- NPI assigned
- Nov 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5851 | PR | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5851 | PR | Yes |
Addresses
Primary practice location
4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519-4844
Mailing address
4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519-4844
Phone (646) 509-4511
Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.