Individual
DAVID W. PERDUE JR.
Active
Individual
DAVID W. PERDUE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
295
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001836147
BLUE CROSS BLUE SHIELD
WV
05
—
010381096
—
VA
01
—
1070558
BRICKSTREET
—
05
—
3810014308
—
WV
Enumeration date
07/27/2006
Last updated
08/28/2015
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