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Individual

PERRY J SEVERANCE

Active
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Individual

PERRY J SEVERANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25579
MN
207RI0200X
Infectious Disease Physician
Primary
25579
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045098700
MEDICAL ASSISTANCE
01
1000006
PREFERRED ONE
01
108496
U-CARE
01
2114131
FIRST HEALTH PLAN
01
449000005
MEDICARE
01
600819
ARAZ GRP/AMERICA'S PPO
01
6D089SE
BLUE CROSS BLUE SHIELD
01
9227216
MEDICA HEALTH PLANS
01
HP22744
HEALTH PARTNERS
Enumeration date
10/17/2005
Last updated
12/13/2011
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