Provider Demographics
NPI:1477575439
Name:MICHAEL A. PERINI, M.D., P.C.
Entity Type:Organization
Organization Name:MICHAEL A. PERINI, M.D., P.C.
Other - Org Name:CHESTERFIELD INTERNAL MEDICINE AND ALLERGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:8047-962-2220
Mailing Address - Street 1:PO BOX 2624
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9124
Mailing Address - Country:US
Mailing Address - Phone:804-796-2220
Mailing Address - Fax:804-796-2997
Practice Address - Street 1:11601 IRON BRIDGE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1466
Practice Address - Country:US
Practice Address - Phone:804-796-2220
Practice Address - Fax:804-796-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230768174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08839Medicare ID - Type UnspecifiedGROUP #
VAH36387Medicare UPIN
VA00V609M39Medicare ID - Type UnspecifiedINDIVIDUAL NO.