Individual
DR. ILYA PEREPELITSYN
Active
Individual
DR. ILYA PEREPELITSYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
219565
MA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
49351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305473200
—
MN
05
—
34756700
—
WI
01
—
AA11436
HARVARD PILGRIM
MA
01
—
J27270
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/28/2005
Last updated
06/13/2013
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