Provider Demographics
NPI:1669867941
Name:PERRY, WILLIAM CHRISTOPHER (DPM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:PERRY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3860 WEDGEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6725
Mailing Address - Country:US
Mailing Address - Phone:516-587-4450
Mailing Address - Fax:
Practice Address - Street 1:3860 WEDGEFIELD CT
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-6725
Practice Address - Country:US
Practice Address - Phone:516-587-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
OH003812213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery