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Individual

PERRY BERHOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555
Mailing address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8806
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-13393
MEDICA
MN
01
01Q58BE
BCBS/MEDICARE SUPPLEMENT
MN
05
07Q58BE
MN
05
118121
MN
01
4042
AVERA
MN
01
595810
ARAZ
MN
05
78816300
MN
05
959478
MN
01
A026
CHAMPUS
MN
01
HP50065
HEALTH PARTNERS
MN
01
MH9041001158
PPO
MN
Enumeration date
12/01/2005
Last updated
07/09/2007
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