Healthcare Provider Details

I. General information

NPI: 1184716474
Provider Name (Legal Business Name): MICHAEL ERIC PERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE SUITE 430
ENGLEWOOD CO
80113-3781
US

IV. Provider business mailing address

601 E HAMPDEN AVE SUITE 430
ENGLEWOOD CO
80113-3781
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8355
  • Fax: 303-788-4448
Mailing address:
  • Phone: 303-788-8355
  • Fax: 303-788-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number31207
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: