MEDICARE: PAOLA PERGAMI MD

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	208D00000X	General Practice Physician	22575	WV

General Provider Information

NPI Number	:	1811199383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAOLA PERGAMI MD

Provider Business Mailing Address
First Line	:	4200 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2143
Country	:	US
Telephone Number	:	202-817-7658
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2143
Country	:	US
Telephone Number	:	202-817-7658
Fax Number	:

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	11/18/2019

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Directions to “ PAOLA PERGAMI MD” Practice Location

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