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NPI Code Detail

MEDICARE: DAVID PERSE MD, LLC

MEDICARE: DAVID PERSE MD, 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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1982212593
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID PERSE MD, LLC
Provider Business Mailing Address
First Line : PO BOX 771545
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-0061
Country : US
Telephone Number : 216-363-7402
Fax Number : 216-363-2796
Provider Business Practice Location Address
First Line : 2401 SCRANTON RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4313
Country : US
Telephone Number : 216-363-7402
Fax Number : 216-363-2796
Authorized Official
Title or Position : OWNER
Name : DAVID F PERSE
Credential : MD
Telephone Number : 216-363-7402
Provider Enumeration Date : 07/20/2020
Last Update Date : 08/22/2023

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