MEDICARE: RUBEN PEREZ MD

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	207RH0003X	Hematology & Oncology Physician	PE133702	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	133702FLT	OTHER	PA	MEDICARE

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
2	02789600	OTHER	PA	CAPITAL BLUE CROSS
4	573400	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1629061452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBEN PEREZ MD

Provider Business Mailing Address
First Line	:	PO BOX 300
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-0300
Country	:	US
Telephone Number	:	717-270-7780
Fax Number	:	717-274-9746

Provider Business Practice Location Address
First Line	:	4TH & WALNUT STREETS
Second Line	:	2ND FLOOR WEST
City	:	LEBANON
State	:	PA
Zip	:	17042-6123
Country	:	US
Telephone Number	:	717-270-8875
Fax Number	:	717-270-2325

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	06/05/2017

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Directions to “ RUBEN PEREZ MD” Practice Location

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