Provider Demographics
NPI:1629062252
Name:PERRY, CATHERINE V (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:V
Last Name:PERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:V
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2320 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6565
Mailing Address - Country:US
Mailing Address - Phone:540-729-3946
Mailing Address - Fax:
Practice Address - Street 1:501 SUNSET LN
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3917
Practice Address - Country:US
Practice Address - Phone:540-829-4189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200425207P00000X
VA0101239862207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00417571OtherRAILRAOD MEDICARE
VA1629062252Medicaid
NC132MCOtherBCBS NC
VA303315OtherBLUE SHIELD
NC89132MCMedicaid
NCP00012994OtherRAILROAD MEDICARE
VA1629062252Medicaid
VA303315OtherBLUE SHIELD
NC89132MCMedicaid