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General NPI Number Information
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NPI Number | 1346296399
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Entity Type | Individual
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Provider Name | PHILIP STEPHEN PERONA MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2510 COMMONS BLVD STE 125
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City | BEAVERCREEK
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State | OH
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Zip | 45431-3835
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Country | US
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Telephone | 662-249-4728
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Fax | 937-558-3026
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Provider Business Mailing Address
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Address Line | 1438 W MARKET ST
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City | LIMA
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State | OH
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Zip | 45805-2311
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Country | US
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Telephone | 419-230-2293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35051486
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License Number State | OH
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