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Individual

DR. RICHARD T PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
23829 LITTLE MACK AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-1186
(586) 773-1300
(586) 773-1600
Mailing address
23829 LITTLE MACK AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-1186
(586) 773-1300
(586) 773-1600

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
RP066358
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0821872
BLUE CROSS BLUE SHIELD
MI
05
3164704
MI
01
C4762
MCARE
MI
Enumeration date
04/06/2006
Last updated
11/27/2012
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