Provider Demographics
NPI:1083609044
Name:PERAUD, JOSEPH BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BERNARD
Last Name:PERAUD
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 1:115 SCHULT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50630-9582
Mailing Address - Country:US
Mailing Address - Phone:563-237-5316
Mailing Address - Fax:563-237-6337
Practice Address - Street 1:115 SCHULT RIDGE RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:IA
Practice Address - Zip Code:50630-9582
Practice Address - Country:US
Practice Address - Phone:563-237-5316
Practice Address - Fax:563-237-6337
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA13039OtherBCBS
IA0130393Medicaid
IA7881OtherMIDLANDS CHOICE
IA2313554OtherUNITED HEALTH CARE
IA13039Medicare PIN
IA2313554OtherUNITED HEALTH CARE