MEDICARE: PERKIS FAMILY MEDICINE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DE6737	OTHER	MD	MEDICARE RR

General Provider Information

NPI Number	:	1457306755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERKIS FAMILY MEDICINE, LLC

Provider Business Mailing Address
First Line	:	349 E PULASKI HWY STE C
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-6747
Country	:	US
Telephone Number	:	410-398-4510
Fax Number	:	410-398-5160

Provider Business Practice Location Address
First Line	:	349 E PULASKI HWY STE C
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-6747
Country	:	US
Telephone Number	:	410-398-4510
Fax Number	:	410-398-5160

Authorized Official
Title or Position	:	OWNER
Name	:	RENEE PERKIS
Credential	:	MD
Telephone Number	:	410-398-4510

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/12/2022

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