Provider Demographics
NPI:1255327607
Name:PEARLMAN, LEE DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:DAVID
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1045 BEECHER XING N
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4573
Mailing Address - Country:US
Mailing Address - Phone:614-304-0019
Mailing Address - Fax:614-304-0023
Practice Address - Street 1:5920 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6881
Practice Address - Country:US
Practice Address - Phone:614-891-9994
Practice Address - Fax:614-891-4141
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002316213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0625274Medicaid
OH10797384OtherCAQH
OHH243220Medicare PIN
OH10797384OtherCAQH
OH10797384OtherCAQH