Provider Demographics
NPI:1558399857
Name:PERKINS, DAVID P (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:PERKINS
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 1:418 E. LANCASTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST. DAVIDS,
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4310
Mailing Address - Country:US
Mailing Address - Phone:610-688-4177
Mailing Address - Fax:
Practice Address - Street 1:418 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:ST DAVIDS
Practice Address - State:PA
Practice Address - Zip Code:19087-4310
Practice Address - Country:US
Practice Address - Phone:610-688-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043606E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA514080Medicare ID - Type Unspecified
F77205Medicare UPIN