Basic Information
| Provider Information | |||||||||
| NPI: | 1073833174 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERTTU | ||||||||
| FirstName: | DARREN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11134 N STATE ROAD 77 | ||||||||
| Address2: | ESSENTIA HEALTH HAYWARD CLINIC | ||||||||
| City: | HAYWARD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548435325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7156345505 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11134 N STATE ROAD 77 | ||||||||
| Address2: | ESSENTIA HEALTH HAYWARD CLINIC | ||||||||
| City: | HAYWARD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548435325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7156345505 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2010 | ||||||||
| LastUpdateDate: | 12/07/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 64227-20 | WI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.