Perido, Dominador T
Perido, Dominador T is an sole proprietor health care provider with primary practice located at 411 Sunset , Elkhart KS 67950-0997. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Perido, Dominador T can be contacted via phone (620) 697-2155.Contact Information
Primary practice address
411 Sunset
Elkhart KS 67950-0997
Phone: (620) 697-2155
Fax: (620) 697-4275
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | KS0416343 | Kansas |
Profile Details
| NPI number | 1770576464 |
|---|---|
| LBN Legal business name | Perido, Dominador T |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Aug 8th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770576464 | NPPES |
| Kansas | MEDICAID | 100085400A |
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