Provider Demographics
NPI:1073833174
Name:PERTTU, DARREN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:WILLIAM
Last Name:PERTTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11134 N STATE ROAD 77
Mailing Address - Street 2:ESSENTIA HEALTH HAYWARD CLINIC
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-5325
Mailing Address - Country:US
Mailing Address - Phone:715-634-5505
Mailing Address - Fax:
Practice Address - Street 1:11134 N STATE ROAD 77
Practice Address - Street 2:ESSENTIA HEALTH HAYWARD CLINIC
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-5325
Practice Address - Country:US
Practice Address - Phone:715-634-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64227-20208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery