Individual
DR. TAMY E PERNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
330 N WABASH, SUITE 370, MARION, IN 46952-2678
(765) 660-7500
(765) 662-4724
Mailing address
123 HOSPITAL DR, STE 2000, WATERTOWN, WI 53098-3320
(765) 660-7616
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0102202410
VA
208600000X
Surgery Physician
Primary
02004094A
IN
208600000X
Surgery Physician
DO2928
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000784523
ANTHEM
IN
05
—
1063628956
—
VA
05
—
201115230
—
IN
Enumeration date
05/15/2007
Last updated
09/16/2019
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