Provider Demographics
NPI:1003850777
Name:PERLSTEIN, HARRIETTE S (MD)
Entity Type:Individual
Prefix:
First Name:HARRIETTE
Middle Name:S
Last Name:PERLSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4035 JOHNS CREEK PARKWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUNWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024
Mailing Address - Country:US
Mailing Address - Phone:770-814-1160
Mailing Address - Fax:770-814-1173
Practice Address - Street 1:4035 JOHNS CREEK PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:SUNWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024
Practice Address - Country:US
Practice Address - Phone:770-814-1160
Practice Address - Fax:770-814-1173
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031098208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G68045Medicare UPIN