Provider Demographics
NPI:1669623237
Name:MICHAEL ERIC PERRY MD PC
Entity type:Organization
Organization Name:MICHAEL ERIC PERRY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-690-4067
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:STE 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:STE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31207207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO290006793OtherRAILROAD MEDICARE
KS290014313OtherRAILROAD MEDICARE
NE290014312OtherRAILROAD MEDICARE
KSPE507005Medicaid
CO01312073Medicaid
CO01312073Medicaid
COC70931Medicare PIN
NE266349Medicare PIN
KS290014313OtherRAILROAD MEDICARE
CO01312073Medicaid