Healthcare Provider Details
I. General information
NPI: 1669623237
Provider Name (Legal Business Name): MICHAEL ERIC PERRY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E HAMPDEN AVE STE 430
ENGLEWOOD CO
80113-3781
US
IV. Provider business mailing address
601 E HAMPDEN AVE STE 430
ENGLEWOOD CO
80113-3781
US
V. Phone/Fax
- Phone: 303-788-8355
- Fax: 303-788-4448
- Phone: 303-788-8355
- Fax: 303-788-4448
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 31207 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
MICHAEL
ERIC
PERRY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 303-690-4067