Provider Demographics
NPI:1588761449
Name:PERRY, MICHAEL F (MD FACOG)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD FACOG
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:F
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:842 NORTH HIGHLAND AVE NE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306
Mailing Address - Country:US
Mailing Address - Phone:404-685-8867
Mailing Address - Fax:404-685-8137
Practice Address - Street 1:842 NORTH HIGHLAND AVE NE
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306
Practice Address - Country:US
Practice Address - Phone:404-685-8867
Practice Address - Fax:404-685-8137
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046900174400000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00912964AMedicaid
GAH49942Medicare UPIN
H49942Medicare UPIN
H49942Medicare UPIN