MEDICARE: KEVIN IRA PERMAN M.D.

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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	D0050928	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457372872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN IRA PERMAN M.D.

Provider Business Mailing Address
First Line	:	6420 ROCKLEDGE DR
Second Line	:	SUITE 4300
City	:	BETHESDA
State	:	MD
Zip	:	20817-7837
Country	:	US
Telephone Number	:	301-571-0000
Fax Number	:	301-571-0853

Provider Business Practice Location Address
First Line	:	6420 ROCKLEDGE DR
Second Line	:	SUITE 4300
City	:	BETHESDA
State	:	MD
Zip	:	20817-7837
Country	:	US
Telephone Number	:	301-571-0000
Fax Number	:	301-571-0853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	10/16/2017

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