Provider Demographics
NPI:1790800092
Name:PERILSTEIN, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:PERILSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13 ARMAND HAMMER BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5067
Mailing Address - Country:US
Mailing Address - Phone:610-327-2405
Mailing Address - Fax:610-327-8765
Practice Address - Street 1:13 ARMAND HAMMER BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5067
Practice Address - Country:US
Practice Address - Phone:610-327-2405
Practice Address - Fax:610-327-8765
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD018220E207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB39893Medicare UPIN