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NPI Code Detail

MEDICARE: DR. SAMUEL H PERRRY II M.D.

MEDICARE: DR. SAMUEL H PERRRY II 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
1208000000XPediatrics Physician12525NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043244098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL H PERRRY II M.D.
Provider Business Mailing Address
First Line : 410 SEAGULL DR
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-8910
Country : US
Telephone Number : 308-534-9230
Fax Number : 308-534-5016
Provider Business Practice Location Address
First Line : 210 MCNEEL LN
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6290
Country : US
Telephone Number : 308-534-9230
Fax Number : 308-534-5016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 07/08/2007

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