Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2012-02341 | NC |
N | 208000000X | Pediatrician | 224904 | MA |
N | 2080A0000X | Adolescent Medicine | 224904 | MA |
NPI | 1023070968 |
---|---|
Provider Name | Dr. Martha Fairbanks Perry |
First Address | Morrisville, NC 27560-8442 |
Second Address | Cary, NC 27519-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 19/08/2021 |