MEDICARE: MICHAEL SHOLOM PERLMAN 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	2084P0800X	Psychiatry Physician	29935	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871561019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SHOLOM PERLMAN MD

Provider Business Mailing Address
First Line	:	57 GOTHIC STREET
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3047
Country	:	US
Telephone Number	:	413-584-6186
Fax Number	:	413-585-0488

Provider Business Practice Location Address
First Line	:	57 GOTHIC STREET
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3047
Country	:	US
Telephone Number	:	413-584-6186
Fax Number	:	413-585-0488

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/02/2012

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