Provider Demographics
NPI:1184716474
Name:PERRY, MICHAEL ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERIC
Last Name:PERRY
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 1:601 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-788-8355
Mailing Address - Fax:303-788-4448
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:303-788-8355
Practice Address - Fax:303-788-4448
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31207207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01312073Medicaid
CO01312073Medicaid
CO70931Medicare PIN
NE266349Medicare PIN
KS111143Medicare PIN