Organization Active NPI

Ralph D Pearlman MD PC

  • Colon & Rectal Surgery Physician
  • Southfield, MI
National Provider Identifier
1114140167
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
RP045454 Issued in MI
Legal business name
RALPH D PEARLMAN MD PC
Practice address
22250 Providence Dr Ste 702
Southfield, MI 48075-6215
Phone
(248) 557-9650
Fax
(248) 557-5033
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ralph Pearlman, MD
Title
President
Phone
(248) 557-9650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X RP045454 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 702
Southfield, MI 48075-6215

Mailing address

22250 Providence Dr Ste 702
Southfield, MI 48075-6215
Phone (248) 557-9650

Other identifiers 1

IdentifierTypeStateIssuer
3194561MedicaidMI

National Provider Directory

National Provider Directory

Locations

22250 Providence Dr
Ste 702
Southfield, MI 48075
Phone (248) 557-9650

22250 Providence Dr
Ste 606
Southfield, MI 48075
Phone (248) 443-1281

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1114140167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 702",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "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 STE 702",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-557-9650",
            "fax_number": "248-557-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH D PEARLMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "PEARLMAN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-557-9650",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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 Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.