Healthcare Provider Details

I. General information

NPI: 1225024375
Provider Name (Legal Business Name): STEVEN B. PERLMUTTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 W GLENDALE AVE SUITE 103
PHOENIX AZ
85021-8578
US

IV. Provider business mailing address

14227 N 69TH PL
SCOTTSDALE AZ
85254-3480
US

V. Phone/Fax

Practice location:
  • Phone: 602-995-2000
  • Fax: 602-995-8408
Mailing address:
  • Phone: 480-368-2922
  • Fax: 480-368-5488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number15219
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: