MEDICARE: DR. FRED BARRY PEARLMAN D.O.

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	208000000X	Pediatrics Physician	34-004965	OH

General Provider Information

NPI Number	:	1861408049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRED BARRY PEARLMAN D.O.

Provider Business Mailing Address
First Line	:	488 LONGSPUR RD
Second Line	:
City	:	HIGHLAND HEIGHTS
State	:	OH
Zip	:	44143-3716
Country	:	US
Telephone Number	:	440-446-0845
Fax Number	:	216-227-1322

Provider Business Practice Location Address
First Line	:	14701 DETROIT AVE
Second Line	:	SUITE 400
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4115
Country	:	US
Telephone Number	:	216-227-1330
Fax Number	:	216-227-1322

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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