MEDICARE: STEVEN J PEREZ 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	207R00000X	Internal Medicine Physician	0101237477	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1164428231	OTHER	VA	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1356357578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN J PEREZ MD PC

Provider Business Mailing Address
First Line	:	6715 LITTLE RIVER TPKE
Second Line	:	201
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3546
Country	:	US
Telephone Number	:	703-914-3640
Fax Number	:	703-914-2536

Provider Business Practice Location Address
First Line	:	6715 LITTLE RIVER TPKE
Second Line	:	201
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3546
Country	:	US
Telephone Number	:	703-914-3640
Fax Number	:	703-914-2536

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEVEN J PEREZ
Credential	:	M.D.
Telephone Number	:	703-914-3640

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	03/13/2008

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