Provider Demographics
NPI:1467443960
Name:PEREZ, ROLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:PEREZ
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 1:10313 GEORGIA AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5006
Mailing Address - Country:US
Mailing Address - Phone:301-681-9101
Mailing Address - Fax:301-681-3525
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:STE 202
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-681-9101
Practice Address - Fax:301-681-3525
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019270207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD09388Medicare UPIN
MD000F63C21Medicare ID - Type Unspecified