MEDICARE: RALPH D PEARLMAN MD PC

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	208C00000X	Colon & Rectal Surgery Physician	RP045454	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1114140167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALPH D PEARLMAN MD PC

Provider Business Mailing Address
First Line	:	22250 PROVIDENCE DR STE 702
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-6215
Country	:	US
Telephone Number	:	248-557-9650
Fax Number	:	248-557-5033

Provider Business Practice Location Address
First Line	:	22250 PROVIDENCE DR STE 702
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-6215
Country	:	US
Telephone Number	:	248-557-9650
Fax Number	:	248-557-5033

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RALPH PEARLMAN
Credential	:	MD
Telephone Number	:	248-557-9650

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	01/08/2010

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