MEDICARE: DR. MICHAEL L. PEARL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0201X	Gynecologic Oncology Physician	196680	NY
2	207VX0201X	Gynecologic Oncology Physician	23918	NH

General Provider Information

NPI Number	:	1043219512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL L. PEARL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 810
Second Line	:
City	:	HANOVER
State	:	NH
Zip	:	03755-0810
Country	:	US
Telephone Number	:	603-308-1453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	LEBANON
State	:	NH
Zip	:	03756-0001
Country	:	US
Telephone Number	:	603-650-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	02/21/2025

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