Pergam Med Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00031059 Issued in WA

Legal business name

PERGAM MED CORP

Practice address

2103 Harrison Ave NW
Suite 2692
Olympia, WA 98502-2636

Phone

(206) 403-6656

NPI assigned

Aug 16, 2010

Last updated

Oct 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Dorney

Title

Ceo

Phone

(206) 403-6656

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1760797674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 HARRISON AVE NW",
            "address_2": "SUITE 2692",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 HARRISON AVE NW",
            "address_2": "SUITE 2692",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022636",
            "telephone_number": "206-403-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERGAM MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "DORNEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-403-6656"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00031059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estefani Perete Gomez
• Miguel Maloney Perez-Gibson
• Martha Janet Perez-Gutierrez
• Viviana Maureen Perez
• Performance Modalities Inc. (Performance Home Medical)
• Robert Lee Perlot Jr., D.M.D, M.S.
• Dana Lynn Permann
• Griselda S Perretz Rosales, PHD
• Robert Perretz-Rosales, MA
• Laurence E Perrin, MD

• Internal Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.