1669478368 NPI number — SCOTT R PERMAN MD

Table of content: SCOTT R PERMAN MD (NPI 1669478368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669478368 NPI number — SCOTT R PERMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERMAN
Provider First Name:
SCOTT
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1669478368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1177 BOSTON PROVIDENCE TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02062-5019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-278-5540
Provider Business Mailing Address Fax Number:
781-762-7623

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1177 BOSTON PROVIDENCE TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWOOD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02062-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-278-5540
Provider Business Practice Location Address Fax Number:
781-762-7623
Provider Enumeration Date:
06/27/2005

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: 207R00000X , with the licence number:  153872 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 110162072 . This is a "RAILROAD/MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27625 . This is a "CHILDREN'S MEDICAL SECURI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68516 . This is a "HARVARD PILGRIM PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68516 . This is a "HARVARD PILGRIM POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G58808 . This is a "FIRST SENIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18316 . This is a "HMO BLUE/BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153872 . This is a "TUFTS TOTAL HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: A23104 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153872 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68516 . This is a "HARVARD/PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18316 . This is a "BS-BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04-41308 . This is a "UNITED HEALTHCARE(PPO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153872 . This is a "TUFTS COMMONWEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3171671 . This is a "MASS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153872 . This is a "TUFTS BENEFIT ADMIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2831971 . This is a "HEALTHSOURCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2831971 . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0016050 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18316 . This is a "BLUE SHIELD-INDEMNITY" identifier . This identifiers is of the category "OTHER".




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