=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669479622
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER J PERKINS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2005
-----------------------------------------------------
Last Update Date | 12/18/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 CHAPEL ST STE 3D
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02062-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-762-2626
-----------------------------------------------------
Fax | 781-762-2627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 CHAPEL ST STE 3D
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02062-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-762-2626
-----------------------------------------------------
Fax | 781-762-2627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 81168
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------