Individual
DR. STEPHANIE WILKS PERDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9811 MALLARD DR, SUITE 109, LAUREL, MD 20708-3143
(301) 776-8000
(301) 776-6753
Mailing address
9811 MALLARD DR, SUITE 109, LAUREL, MD 20708-3143
(301) 776-8000
(301) 776-6753
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D0073561
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063563400
—
MD
Enumeration date
03/15/2007
Last updated
06/07/2013
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