Provider Demographics
NPI:1609973767
Name:PERRYMAN, STEVEN T (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:PERRYMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1211
Mailing Address - Country:US
Mailing Address - Phone:508-435-4711
Mailing Address - Fax:508-435-5053
Practice Address - Street 1:10 CEDAR ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1222
Practice Address - Country:US
Practice Address - Phone:508-435-4711
Practice Address - Fax:508-435-5053
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4168152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0003212Medicaid
MA0313823Medicaid
MA0003212Medicaid