Active NPI
Ralph Donald Pearlman, MD
- Colon & Rectal Surgery Physician
- Southfield, MI
National Provider Identifier
1033125992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- RP045454
- Practice address
- 22250 Providence Dr
Ste #702
Southfield, MI 48075 - Phone
- (248) 557-9650
- Fax
- (248) 557-5033
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | RP045454 | MI | Primary |
Addresses
Primary practice location
22250 Providence Dr
Ste #702
Southfield, MI 48075
Mailing address
22250 Providence Dr
Ste #702
Southfield, MI 48075
Phone (248) 557-9650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3194561 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP045454 | MI | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033125992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22250 PROVIDENCE DR",
"address_2": "STE #702",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48075",
"telephone_number": "248-557-9650",
"fax_number": "248-557-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22250 PROVIDENCE DR",
"address_2": "STE #702",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48075",
"telephone_number": "248-557-9650",
"fax_number": "248-557-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARLMAN",
"first_name": "RALPH",
"middle_name": "DONALD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "MI",
"license": "RP045454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3194561",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.