Individual
CARL J PERGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
677 N WILMOT RD, TUCSON, AZ 85711-2701
(520) 795-2889
(520) 795-6321
Mailing address
677 N WILMOT RD, TUCSON, AZ 85711-2701
(520) 795-2889
(520) 795-6321
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
29455
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
638512
—
AZ
Enumeration date
01/27/2006
Last updated
02/05/2009
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