Provider Demographics
NPI:1497832000
Name:PERRAUT, LOUIS EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:EDWARD
Last Name:PERRAUT
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 1:8220 BURNING TREE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 120
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4361
Practice Address - Country:US
Practice Address - Phone:240-575-9713
Practice Address - Fax:240-575-9792
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24984207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C88480Medicare UPIN