Individual
MR. EDUARDO V PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
101 S WASHINGTON ST, SUITE 200, MARION, IN 46952-3867
(765) 662-9971
(765) 651-6566
Mailing address
1814 W 500 N, MARION, IN 46952-9107
(765) 664-7364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001263A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004027
MPLAN PROV ID
IN
01
—
000000183231
ANTHEM PROVIDER ID
IN
01
—
000000317611
GENCORP PROVIDER ID
IN
01
—
0005477491
AETNA PROVIDER ID
IN
01
—
088367428001
GENERAL LIC #
IN
01
—
158079
VALUE OPTIONS PROV ID
IN
01
—
I014647
TRICARE PROVIDER ID
IN
01
—
LIC34001263A
GENERAL MOTORS PROV ID
IN
Enumeration date
01/09/2007
Last updated
07/09/2007
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