Gregory P. Derderian D.O., P.C. in Clarkston - Vascular Surgery
Gregory P. Derderian D.O., P.C. - NPI 1922108240
Gregory P. Derderian D.O., P.C. is a Vascular Surgery in Clarkston, Michigan. Gregory P. Derderian D.O., P.C. practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for Gregory P. Derderian D.O., P.C. is 1922108240. The last update date is 2020-08-22.
Gregory P. Derderian D.O., P.C.'s current location address is 6770 Dixie Hwy, Clarkston, Michigan. You can contact this provider via phone number 2489229371 and fax number 5864933828. The mailing address for Gregory P. Derderian D.O., P.C. is 6770 Dixie Hwy, Clarkston, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gregory P. Derderian D.O., P.C. |
|---|---|
| Address | 6770 Dixie Hwy, Clarkston, Michigan |
| Phone Number | 2489229371 |
| Fax Number | 5864933828 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDEENT |
|---|---|
| Authorized Official Name | Derderian P Gregory |
| Credentials | M.D. |
| Telephone Number | 5864933175 |
NPI Number Detail
| NPI Number | 1922108240 |
|---|---|
| Provider Enumeration Date | 2006-09-25 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 6770 Dixie Hwy |
|---|---|
| City | Clarkston |
| State | Michigan (MI) |
| Post Code | 483462087 |
| Phone Number | 2489229371 |
| Fax Number | 5864933828 |
Provider's Primary Taxonomy Detail
| Speciality | Vascular Surgery |
|---|---|
| Taxonomy | 2086S0129X |
| Licence No | 5101007182 |
|
Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4406461 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Gregory P. Derderian D.O., P.C. by the Centers for Medicare & Medicaid Services?
The Gregory P. Derderian D.O., P.C. has been assigned the NPI (National Provider Identifier) 1922108240. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Gregory P. Derderian D.O., P.C. is geographically located?
The Gregory P. Derderian D.O., P.C. is physically situated at the following location: 6770 Dixie Hwy, Clarkston, MI, 483462087.
What is the area of specialization for Gregory P. Derderian D.O., P.C., and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Gregory P. Derderian D.O., P.C. is Vascular Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 2086S0129X.
On what date did the Gregory P. Derderian D.O., P.C. receive its 1922108240 assignment from the Centers for Medicare & Medicaid Services?
The Gregory P. Derderian D.O., P.C. was assigned its 1922108240 by the Centers for Medicare & Medicaid Services on 2006-09-25.
As of what date were the details related to Gregory P. Derderian D.O., P.C. most recently updated or revised?
The information pertaining to Gregory P. Derderian D.O., P.C., including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC
NPI Number: 1063415297
Address: 510 Spring St, Jeffersonville, IN