Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD61165377 | WA |
N | 208200000X | Surgeon | A133182 | CA |
N | 208600000X | Surgeon | A133182 | CA |
NPI | 1639503386 |
---|---|
Provider Name | Andrew M Perry |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2013 |
Last Update Date | 17/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1639503386 | (05) | WA |