Provider Demographics
NPI:1376130062
Name:PERDUE, DEENEM Y
Entity Type:Individual
Prefix:
First Name:DEENEM
Middle Name:Y
Last Name:PERDUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 HOPELAND ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4029
Mailing Address - Country:US
Mailing Address - Phone:937-830-3629
Mailing Address - Fax:
Practice Address - Street 1:433 HOPELAND ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4029
Practice Address - Country:US
Practice Address - Phone:937-830-3629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)