Basic Information
Provider Information
NPI: 1558586073
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERDUE
FirstName: AARON
MiddleName: MATTHEW
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 E MEDICAL CENTER DR
Address2: 2ND FLOOR TAUBMAN CENTER RECP B
City: ANN ARBOR
State: MI
PostalCode: 481095000
CountryCode: US
TelephoneNumber: 7349365780
FaxNumber: 7349368164
Other Information
ProviderEnumerationDate: 04/17/2007
LastUpdateDate: 04/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X4301084641MIY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0801X45006TNN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
207XX0801XMD45006TNN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma

No ID Information.


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