Provider Demographics
NPI:1790774370
Name:PERLA, BERNARD D (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:D
Last Name:PERLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:36100 EUCLID AVE
Mailing Address - Street 2:STE 450
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4456
Mailing Address - Country:US
Mailing Address - Phone:440-946-9555
Mailing Address - Fax:440-946-2223
Practice Address - Street 1:36100 EUCLID AVE
Practice Address - Street 2:STE 450
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4456
Practice Address - Country:US
Practice Address - Phone:440-946-9555
Practice Address - Fax:440-946-2223
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2021-04-01
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Provider Licenses
StateLicense IDTaxonomies
OH35063312207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0167439Medicaid
OH0167439Medicaid
OH0785474Medicare ID - Type Unspecified