DR. STEPHANIE WILKS PERDUE (NPI# 1073647442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073647442 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE WILKS PERDUE |
| Credential | M.D. |
| Practice Address |
9811 Mallard Dr Suite 109 Laurel MD 20708-3143 |
| Practice Telephone | 3017768000 |
| Practice Fax Number | 3017766753 |
| Mailing Telephone | 3017768000 |
| Mailing Fax Number | 3017766753 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2013-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
D0073561 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 063563400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417328790 | Stephanie Perdue | Behavioral Analyst | 2905 Palo Alto Dr Ne, Albuquerque, NM 87112-2126 | 2015-10-13 |
| 1619466562 | Stephanie Carla Perdue | Social Worker | 205 E Crosier St, Akron, OH 44311-2351 | 2018-05-07 |
| 1992999478 | Stephanie Perdue | Social Worker | 2505 Kingston Pike, Knoxville, TN 37919-3313 | 2007-08-28 |
| 1326094400 | Stephanie Ann Perdue | Physician Assistant | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2006-05-26 |
| Street Address |
9811 MALLARD DR SUITE 109 |
| City | LAUREL |
| State | MD |
| Zip Code | 20708-3143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477533230 | Swapna Abhyankar | Specialist | 9811 Mallard Dr, Suite 109, Laurel, MD 20708-3143 | 2006-01-18 |
| 1851772032 | Augustus C. Dickens | Counselor | 9811 Mallard Dr, Laurel, MD 20708-3143 | 2015-06-14 |
| 1417377748 | Shannon M Hawk | Chiropractor | 9811 Mallard Dr, Ste 218, Laurel, MD 20708-3143 | 2014-04-25 |
| 1134461940 | Agas Medical Group, LLC | General Practice | 9811 Mallard Dr, Suite # 213, Laurel, MD 20708-3143 | 2013-03-19 |
| 1629334867 | Emily Catherine Skoda-mount | Pediatrics | 9811 Mallard Dr, Suite # 109, Laurel, MD 20708-3143 | 2012-04-02 |
| 1376823823 | Therapy @ 9811 Inc | Counselor | 9811 Mallard Dr, Suite 210/211, Laurel, MD 20708-3143 | 2011-08-27 |
| 1477886802 | Stephen R. Damm, M.d., P.a. | Dermatology | 9811 Mallard Dr, Suite 220, Laurel, MD 20708-3143 | 2009-09-17 |
| 1982878997 | Karenga R Lemmons, M.d., L.L.C. | Specialist | 9811 Mallard Dr, Ste 211, Laurel, MD 20708-3143 | 2008-04-22 |
| 1962674721 | Laurel Regional Chiropractic, LLC | Chiropractor | 9811 Mallard Dr, Suite 218, Laurel, MD 20708-3143 | 2008-04-01 |
| 1205979903 | Martha Jane Horn | Counselor | 9811 Mallard Dr, Suite 211, Laurel, MD 20708-3143 | 2007-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649880626 | Oak Healthcare Services LLC | Nurse Practitioner | 11601 Duckettown Road, Laurel, MD 20708 | 2020-08-05 |
| 1588287072 | Rebecca Sim | Social Worker | 14112 Bramble Court, Apt 101, Laurel, MD 20708 | 2020-05-19 |
| 1265082978 | Leslie Duncan | Nurse Practitioner | 12908 Golden Oak Dr, Laurel, MD 20708 | 2019-09-14 |
| 1043872310 | Josephine Edet | Driver | 8401 Snowden Loop Ct, Laurel, MD 20708 | 2019-07-07 |
| 1073083655 | Mamta Sampemane | Occupational Therapist | 14409 Greenview Drive Ste 102, Laurel, MD 20708 | 2018-11-27 |
| 1669950275 | Ngendap Tengen Coreen | Home Health Aide | 13009 Mistletoe Spring Rd Apt 516, Laurel, MD 20708 | 2018-08-06 |
| 1447737994 | Chelsey Nicole Garwood | Technician | 9614 Muirkirk Rd, Apt C166, Laurel, MD 20708 | 2018-07-26 |
| 1730665951 | Agnes Aka Nkafu | Home Health Aide | 9017 Contee Rd Apt 302, Laurel, MD 20708 | 2018-07-11 |
| 1568988756 | Olabisi Ntumngia | Home Health Aide | 8903 Ascot Lane, Apt 11, Laurel, MD 20708 | 2017-08-18 |
| 1376083014 | Amiable Home Health Inc. | Home Health | 10120 Bignonia Drive, Laurel, MD 20708 | 2017-02-28 |
| Find all providers in zip 20708 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386191419 | Ganesan,jhansi R. Md, PC | Pediatrics | 8355 Cherry Ln, Laurel, MD 20707-4829 | 2016-09-07 |
| 1447507009 | S.ali A Naqvi | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2012-08-13 |
| 1780682765 | Sujata Qasba | Pediatrics | 3450 Fort Meade Rd, Suite #103, Laurel, MD 20724-2040 | 2005-07-13 |
| 1144696220 | Kingskids Physicians, LLC | Pediatrics | 13932 Baltimore Ave, 11, Laurel, MD 20707-5000 | 2015-08-12 |
| 1194111666 | Grant Patrick Saxton | Pediatrics | 1002 Jefferson Street, Suite 200, Laurel, MS 39440-4306 | 2015-04-11 |
| 1821342379 | South Central Regional Medical Center | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2012-11-06 |
| 1316975394 | South Central Clinics, Inc | Pediatrics | 1002 Jefferson Street, Suite 200, Laurel, MS 39440 | 2006-06-29 |
| 1164460044 | Bert E Bradford | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821621707 | Montgomery County Maryland Government | Pediatrics | 19401 Crystal Rock Dr, Germantown, MD 20874-1593 | 2020-02-19 |
| 1346582244 | Katherine Maureen Carlin | Pediatrics | Johns Hopkins School of Medicine, 733 North Broadway, Suite 147, Baltimore, MD 21205-2196 | 2013-03-19 |
| 1316286032 | Prime Pediatrics, LLC | Pediatrics | 845 Quince Orchard Blvd Ste B, Gaithersburg, MD 20878-1676 | 2013-02-01 |
| 1346401189 | Rose - Marie St Jean Sylla | Pediatrics | 5209 Eliots Oak Rd, Columbia, MD 21044-1826 | 2008-06-24 |
| 1013123876 | Janet V Johnson | Pediatrics | 3311 Toledo Ter Ste C201, Hyattsville, MD 20782-8148 | 2007-05-15 |
| 1366573784 | Shelley Jane Parr | Pediatrics | University Health Ctr, Bldg. 140, College Park, MD 20742-4711 | 2007-03-08 |
| 1528198652 | Cheryl Lynn Parks | Pediatrics | 3527 N Rolling Rd, Suite 1, Baltimore, MD 21244-2223 | 2007-03-07 |
| 1265563001 | Sacared Bodison | Pediatrics | University Health Center - University of Maryland, Building 140, College Park, MD 20742 | 2007-03-07 |
| 1851433965 | Karakat S & Indira V Gokulanathan Ptr | Pediatrics | 9470 Annapolis Rd Ste 311, Lanham, MD 20706-3022 | 2007-02-13 |
| 1528104452 | Maegan Chaney | Pediatrics | 2568a Riva Rd Ste 103, Annapolis, MD 21401-7457 | 2007-01-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. STEPHANIE WILKS PERDUE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.