Provider Demographics
NPI:1699861948
Name:PEARLMAN, MICHAEL X (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PEARLMAN
Suffix:X
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SALEM END RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5565
Mailing Address - Country:US
Mailing Address - Phone:617-620-2230
Mailing Address - Fax:240-526-8207
Practice Address - Street 1:256 SALEM END RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5565
Practice Address - Country:US
Practice Address - Phone:617-620-2230
Practice Address - Fax:240-526-8207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA336012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1307126Medicaid
MA1307126Medicaid
MAB07110Medicare ID - Type Unspecified