MEDICARE: DR. SCOTT VERNON PERRYMAN 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	208600000X	Surgery Physician	A85617	CA

General Provider Information

NPI Number	:	1083800999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT VERNON PERRYMAN M.D.

Provider Business Mailing Address
First Line	:	651 1ST ST W
Second Line	:	STE K
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3076

Provider Business Practice Location Address
First Line	:	651 1ST ST W
Second Line	:	STE K
City	:	SONOMA
State	:	CA
Zip	:	95476-7045
Country	:	US
Telephone Number	:	707-938-3870
Fax Number	:	707-938-3076

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

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	02/20/2013

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