Provider Demographics
NPI:1386649424
Name:PEREZ, MARIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:D
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1701 AUGUSTINE CUT OFF
Mailing Address - Street 2:BUILDING 1, SUITE 12
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4415
Mailing Address - Country:US
Mailing Address - Phone:302-571-0730
Mailing Address - Fax:302-571-0357
Practice Address - Street 1:1701 AUGUSTINE CUT OFF
Practice Address - Street 2:BUILDING 1, SUITE 12
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4415
Practice Address - Country:US
Practice Address - Phone:302-571-0730
Practice Address - Fax:302-571-0357
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10001604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000032601Medicaid
DE6032OtherCOVENTRY HEALTHCARE
DE4313374OtherAETNA
DE0000032601Medicaid
DE4313374OtherAETNA