Provider Demographics
NPI:1508992934
Name:AN, PERRY G (MD)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:G
Last Name:AN
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 1:2014 WASHINGTON STREET
Mailing Address - Street 2:NWH, 2ND FLOOR, HOSPITALIST OFFICE
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462
Mailing Address - Country:US
Mailing Address - Phone:617-243-6433
Mailing Address - Fax:617-243-5148
Practice Address - Street 1:2014 WASHINGTON STREET
Practice Address - Street 2:NWH, 2ND FLOOR, HOSPITALIST OFFICE
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-243-6433
Practice Address - Fax:617-243-5148
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-224456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine