Provider Demographics
NPI:1689666190
Name:PERIM, DAVID MARK (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:PERIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1400 FOREST GLEN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-589-3324
Mailing Address - Fax:301-681-7575
Practice Address - Street 1:1400 FOREST GLEN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-589-3324
Practice Address - Fax:301-681-7575
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2010-02-26
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Provider Licenses
StateLicense IDTaxonomies
MDA43617207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521304947OtherTAX ID
1689666190Medicare PIN
MDA29714Medicare UPIN