Provider Demographics
NPI:1295906642
Name:ERIC S. PERRY, DO, PC
Entity type:Organization
Organization Name:ERIC S. PERRY, DO, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-212-3097
Mailing Address - Street 1:PO BOX 675443
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-5443
Mailing Address - Country:US
Mailing Address - Phone:734-212-3097
Mailing Address - Fax:734-212-3114
Practice Address - Street 1:37000 WOODWARD AVE STE 350
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0944
Practice Address - Country:US
Practice Address - Phone:734-212-3097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIC S PERRY DO PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-13
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty