Provider Demographics
NPI:1770475923
Name:PERKINS, MAXWELL P (MD)
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:P
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAX
Other - Middle Name:P
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:402 N MERIDIAN ST APT 709
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1794
Mailing Address - Country:US
Mailing Address - Phone:317-372-4150
Mailing Address - Fax:
Practice Address - Street 1:402 N MERIDIAN ST APT 709
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1794
Practice Address - Country:US
Practice Address - Phone:317-372-4150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN96575647353478648208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice