Healthcare Provider Details

I. General information

NPI: 1164589420
Provider Name (Legal Business Name): GARY S. PERLMUTTER, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAWTHORNE PL SUITE 105
BOSTON MA
02114-2333
US

IV. Provider business mailing address

PO BOX 9142
CHARLESTOWN MA
02129-9142
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-8656
  • Fax:
Mailing address:
  • Phone: 617-726-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY S. PERLMUTTER
Title or Position: OWNER
Credential: M.D., P.C.
Phone: 617-726-8656