Provider Demographics
NPI:1003958620
Name:PERRY, EVERETT L (MD)
Entity Type:Individual
Prefix:
First Name:EVERETT
Middle Name:L
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PEACHTREE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3131
Mailing Address - Country:US
Mailing Address - Phone:828-254-1969
Mailing Address - Fax:828-254-4611
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3131
Practice Address - Country:US
Practice Address - Phone:828-254-1969
Practice Address - Fax:828-254-4611
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600381207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891283XMedicaid
NC2279109BMedicare ID - Type Unspecified