1427184191 NPI number — DR. RENEE CARTER-PERPALL D.P.M.

Table of content: DR. RENEE CARTER-PERPALL D.P.M. (NPI 1427184191)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427184191 NPI number — DR. RENEE CARTER-PERPALL D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER-PERPALL
Provider First Name:
RENEE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427184191
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2138
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOWIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20718-2138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-805-9308
Provider Business Mailing Address Fax Number:
301-805-9309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4000 MITCHELLVILLE RD
Provider Second Line Business Practice Location Address:
SUITE A304
Provider Business Practice Location Address City Name:
BOWIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20716-3133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-805-9308
Provider Business Practice Location Address Fax Number:
301-805-9309
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213EP1101X , with the licence number:  00648 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213EP1101X , with the licence number: PO368 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 146236 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1125087 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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