Provider Demographics
NPI:1790735868
Name:PERLMUTTER, DONALD ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALAN
Last Name:PERLMUTTER
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 1:9224 DARROW RD
Mailing Address - Street 2:N,O,P
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1897
Mailing Address - Country:US
Mailing Address - Phone:330-425-2020
Mailing Address - Fax:330-777-0124
Practice Address - Street 1:9224 DARROW RD
Practice Address - Street 2:N,O,P
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1897
Practice Address - Country:US
Practice Address - Phone:330-425-2020
Practice Address - Fax:330-777-0124
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3137-961152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT46962Medicare UPIN
OH0452471Medicare PIN
OH9267161Medicare PIN