Healthcare Provider Details

I. General information

NPI: 1669418836
Provider Name (Legal Business Name): WILLIAM MICHAEL PERRI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WALNUT ST STE 100
LEMOYNE PA
17043
US

IV. Provider business mailing address

3 WALNUT ST STE 100
LEMOYNE PA
17043-1168
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-4141
  • Fax: 717-761-1456
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS011925
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: