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NPI Code Detail

MEDICARE: JAMES C PERT M.D.

MEDICARE: JAMES C PERT 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 Physician52249MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1052249OTHERMATUFTS
2PP176OTHERMAHARVARD PILGRIM
30015130OTHERMANEIGHBORHOOD HEALTH
4J03381OTHERMABLUE CROSS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710967708
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES C PERT M.D.
Provider Business Mailing Address
First Line : 147 MILK ST
Second Line : PROVIDER ENROLLMENT - 9TH FLOOR
City : BOSTON
State : MA
Zip : 02109-4806
Country : US
Telephone Number : 617-559-8053
Fax Number : 617-421-3487
Provider Business Practice Location Address
First Line : 26 CITY HALL MALL
Second Line :
City : MEDFORD
State : MA
Zip : 02155-4754
Country : US
Telephone Number : 781-306-5100
Fax Number : 781-306-5379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 07/08/2007

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