Individual
DR. JEDIDIAH JAMES PERKEREWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Mailing address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
54222
MN
207VX0000X
Obstetrics Physician
11956
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16234
—
ND
Enumeration date
07/13/2007
Last updated
04/29/2022
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