Provider Demographics
NPI:1669456844
Name:PERRIAN, ALEXANDER M (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:M
Last Name:PERRIAN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:520-290-0300
Mailing Address - Fax:520-298-9230
Practice Address - Street 1:6365 E TANQUE VERDE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3830
Practice Address - Country:US
Practice Address - Phone:520-290-0300
Practice Address - Fax:520-298-9230
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2016-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1Z7530OtherHEALTHNET
002000166OtherCIGNA
1420406OtherUNITED HEALTHCARE
110111218OtherRR MEDICARE
98985OtherPACIFICARE SECRUE HORIZON
AZ0380220OtherBLUE CROSS BLUE SHIELD
1420406OtherUNITED HEALTHCARE
AZ0380220OtherBLUE CROSS BLUE SHIELD