MEDICARE: GILBERT B PEREZ 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	207Q00000X	Family Medicine Physician	MD441480	PA

General Provider Information

NPI Number	:	1659575041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT B PEREZ M.D.

Provider Business Mailing Address
First Line	:	211 EASY ST
Second Line	:	SUITE 127
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-3129
Country	:	US
Telephone Number	:	724-430-8755
Fax Number	:	724-434-1659

Provider Business Practice Location Address
First Line	:	111B ROBERTS RD
Second Line	:
City	:	GRINDSTONE
State	:	PA
Zip	:	15442-1105
Country	:	US
Telephone Number	:	724-785-2286
Fax Number	:	724-785-3187

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/02/2012

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