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General NPI Number Information
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NPI Number | 1861408049
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Entity Type | Individual
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Provider Name | FRED BARRY PEARLMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14701 DETROIT AVE SUITE 400
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City | LAKEWOOD
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State | OH
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Zip | 44107-4115
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Country | US
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Telephone | 216-227-1330
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Fax | 216-227-1322
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Provider Business Mailing Address
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Address Line | 488 LONGSPUR RD
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City | HIGHLAND HEIGHTS
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State | OH
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Zip | 44143-3716
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Country | US
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Telephone | 440-446-0845
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Fax | 216-227-1322
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34-004965
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License Number State | OH
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