Individual
DR. LARRY CHARLES PEARSON
Active
Individual
DR. LARRY CHARLES PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
21803
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110094338
RAILROAD MEDICARE
WI
05
—
30304600
—
WI
01
—
387464687004
BLUE CROSS/ BLUE SHIELD
WV
Enumeration date
08/04/2005
Last updated
10/31/2019
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