Basic Information
| Provider Information | |||||||||
| NPI: | 1912980939 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERCH | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020A E BOAL AVE | ||||||||
| Address2: | |||||||||
| City: | BOALSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168271509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142378627 | ||||||||
| FaxNumber: | 8142380083 | ||||||||
| Practice Location | |||||||||
| Address1: | 1240 S CEDAR CREST BLVD STE 401 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181036218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104027880 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2005 | ||||||||
| LastUpdateDate: | 09/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD051483L | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 0662018 | 01 | PA | KEYSTONE HEALTH PLAN CENT | OTHER | 1081655 | 01 | PA | KEYSTONE MERCY | OTHER | 1506386 | 01 | PA | GATEWAY HEALTH PLAN | OTHER | 131044 | 01 | PA | MEDPLUS/THREE RIVERS | OTHER | 01218901 | 01 | PA | CAPITAL BC | OTHER | 0784691000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 1081655 | 01 | PA | AMERIHEALTH MERCY | OTHER | 920001781 | 01 | PA | RAILROAD MEDICARE | OTHER | 0015404100003 | 05 | PA | MEDICAID | 66814 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 6797443003 | 01 | PA | CIGNA HMO | OTHER | 662018 | 01 | PA | BCBS PA | OTHER |