MEDICARE: ANTHONY PERRE 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	207R00000X	Internal Medicine Physician	MD060147L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	21198960001	OTHER	KEYSTONE LIAISON
2	4708888939	OTHER	FIRST HEALTH CCN
3	35061	OTHER	INTERCOUNTY
4	1058223	OTHER	KEYSTONE MERCY HEALTHPLAN
5	007302	OTHER	AETNA PPO MANAGED CARE
6	PC0137	OTHER	HEALTH NET
7	007302	OTHER	AETNA HMO
8	2119896001	OTHER	AMERIHEALTH ADMINISTRATOR
9	4708888939	OTHER	DEVON
10	21198960001	OTHER	KEYSTONE HEALTH EAST 65
11	2119896001	OTHER	AMERIHEALTH HMO
12	47088939	OTHER	MAMSI
13	P1134389	OTHER	OXFORD
14	21198960001	OTHER	KEYSTONE HEALTH PLAN EAST
15	P1134389	OTHER	MULTI PLAN

General Provider Information

NPI Number	:	1982688826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY PERRE MD

Provider Business Mailing Address
First Line	:	1331 E WYOMING AVE
Second Line	:	SUITE 4040
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-7542
Fax Number	:	215-537-7884

Provider Business Practice Location Address
First Line	:	1331 E WYOMING AVE
Second Line	:	SUITE 4040
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-7542
Fax Number	:	215-537-7884

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/08/2007

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Directions to “ ANTHONY PERRE MD” Practice Location

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