Individual
JAY PERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, N5W40, BALTIMORE, MD 21201-1544
(410) 328-6749
(410) 328-7305
Mailing address
PO BOX 62063, BALTIMORE, MD 21264-2063
(410) 706-5181
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D30979
MD
2080P0206X
Pediatric Gastroenterology Physician
38758
KY
2080P0206X
Pediatric Gastroenterology Physician
Primary
D30979
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354651900
—
MD
05
—
64082431
—
KY
Enumeration date
07/15/2006
Last updated
08/19/2013
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