Provider Demographics
NPI:1679540256
Name:PEREZ, PEDRO J (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:J
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:640 S STATE ST
Mailing Address - Street 2:742 BUILDING
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-674-3970
Mailing Address - Fax:302-672-2350
Practice Address - Street 1:802 N DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1006
Practice Address - Country:US
Practice Address - Phone:302-422-6050
Practice Address - Fax:302-422-6685
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2012-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC10005847207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001022001Medicaid
DE0001022001Medicaid
H19703Medicare UPIN