MEDICARE: DR. ROBERT THOMAS PERO MD, MPH

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	35.052455	OH

General Provider Information

NPI Number	:	1972583631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT THOMAS PERO MD, MPH

Provider Business Mailing Address
First Line	:	9060 113TH ST
Second Line	:
City	:	BLUE GRASS
State	:	IA
Zip	:	52726-9502
Country	:	US
Telephone Number	:	563-381-1215
Fax Number	:	309-782-0289

Provider Business Practice Location Address
First Line	:	BUILDING 110 SOUTH RODMAN AVENUE
Second Line	:
City	:	ROCK ISLAND ARSENAL
State	:	IL
Zip	:	61299
Country	:	US
Telephone Number	:	309-782-0804
Fax Number	:	309-782-0810

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	02/10/2012

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