Provider Demographics
NPI:1124192646
Name:PERKINS, DENISE WHITE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:WHITE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST
Mailing Address - Street 2:7800 WEST OUTER DRIVE
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-653-2300
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST
Practice Address - Street 2:7800 WEST OUTER DRIVE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-653-2300
Practice Address - Fax:313-653-2660
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080H262390OtherBLUE CROSS-BLUE CROSS
DW069356OtherCOMMERCIAL-COMMERCIAL NUMBER
DW069356OtherCHAMPUS-CHAMPUS
MI338430510Medicaid