Provider Demographics
NPI:1902667140
Name:PEREZ, ALEJANDRA SALAZAR
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:SALAZAR
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6564 E MICHIGAN AVE TRLR 127
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9252
Mailing Address - Country:US
Mailing Address - Phone:734-678-6213
Mailing Address - Fax:
Practice Address - Street 1:6564 E MICHIGAN AVE TRLR 127
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9252
Practice Address - Country:US
Practice Address - Phone:734-678-6213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant