Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MB09323200 | NJ |
N | 111NI0900X | Internist | 25MB09323200 | NJ |
N | 207R00000X | Internist | DR.0057253 | CO |
N | 111NI0900X | Internist | DR.0057253 | CO |
Y | 207RC0000X | Internist - Cardiovascular Disease | DR.0057253 | CO |
NPI | 1023337698 |
---|---|
Provider Name | Michael David Perry |
First Address | Colorado Springs, CO 80909-5533 |
Second Address | Colorado Springs, CO 80909-5533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 02/08/2016 |