Perdue, Stephanie Wilks
Perdue, Stephanie Wilks is an individual health care provider with primary practice located at 9811 Mallard Dr Suite 109, Laurel MD 20708-3143. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Perdue, Stephanie Wilks can be contacted via phone (301) 776-8000.Contact Information
Primary practice address
9811 Mallard Dr Suite 109
Laurel MD 20708-3143
Phone: (301) 776-8000
Fax: (301) 776-6753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | D0073561 | Maryland |
Profile Details
| NPI number | 1073647442 |
|---|---|
| LBN Legal business name | Perdue, Stephanie Wilks |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2007 |
| Last updated | Jun 7th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073647442 | NPPES |
| Maryland | MEDICAID | 063563400 |
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