Healthcare Provider Details

I. General information

NPI: 1649722166
Provider Name (Legal Business Name): KEVIN I. PERMAN , MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 ROCKLEDGE DR SUITE 4300
BETHESDA MD
20817-7837
US

IV. Provider business mailing address

6420 ROCKLEDGE DR SUITE 4300
BETHESDA MD
20817-7837
US

V. Phone/Fax

Practice location:
  • Phone: 301-571-0000
  • Fax: 301-571-0853
Mailing address:
  • Phone: 301-571-0000
  • Fax: 301-571-0853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN I. PERMAN
Title or Position: SURGEON
Credential: MD
Phone: 301-571-0000