Basic Information
Provider Information
NPI: 1578553541
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEREZ
FirstName: RODNEY
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 191 BILTMORE AVE
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288014109
CountryCode: US
TelephoneNumber: 8282540881
FaxNumber: 8283503628
Practice Location
Address1: 191 BILTMORE AVE
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288014109
CountryCode: US
TelephoneNumber: 8282540881
FaxNumber: 8283503628
Other Information
ProviderEnumerationDate: 10/21/2005
LastUpdateDate: 02/01/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X NCY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
1259F01NCBCBS OF NCOTHER
198435601NCUNITED HEALTHCAREOTHER
891259F05NC MEDICAID


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