Polverini, Peter J
Polverini, Peter J is an sole proprietor health care provider with primary practice located at 1011 N University Ave , Ann Arbor MI 48109-1078. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Dental Providers / Oral and Maxillofacial Pathology. Dental Providers / Oral and Maxillofacial Pathology is his primary health care specialty. Polverini, Peter J can be contacted via phone (734) 763-6933.Contact Information
Primary practice address
1011 N University Ave
Ann Arbor MI 48109-1078
Phone: (734) 763-6933
Fax: (734) 763-5142
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2901016040 | Michigan |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 2901016040 | Michigan |
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | 2901016040 | Michigan |
Profile Details
| NPI number | 1699808857 |
|---|---|
| LBN Legal business name | Polverini, Peter J |
| Credentials | DDS, DMSC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2007 |
| Last updated | Jan 29th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699808857 | NPPES |
| Michigan | MEDICAID | 4504373 | |
| Michigan | MEDICAID | 4070694 | |
| Michigan | Other | 195816845 | |
| Michigan | MEDICAID | 2667583 | |
| Michigan | MEDICAID | 4874042 | |
| Michigan | Other | D160400 |
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