Healthcare Provider Details

I. General information

NPI: 1699744623
Provider Name (Legal Business Name): CHERYL E PERKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BERMUDA RUN
STATESBORO GA
30458-0858
US

IV. Provider business mailing address

1044 BERMUDA RUN
STATESBORO GA
30458-0858
US

V. Phone/Fax

Practice location:
  • Phone: 912-618-9593
  • Fax: 912-871-5562
Mailing address:
  • Phone: 912-871-4847
  • Fax: 912-871-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036430
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: