Derderian, Gregory Paul

Derderian, Gregory Paul is an individual health care provider with primary practice located at 538 N Old Woodward Ave , Birmingham MI 48009-5375. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Derderian, Gregory Paul can be contacted via phone (248) 594-3091.

Contact Information

Primary practice address
538 N Old Woodward Ave Birmingham MI 48009-5375
Phone: (248) 594-3091
Fax: (248) 594-3068
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 5101007182 Michigan

Profile Details

NPI number 1457355737
LBN Legal business name Derderian, Gregory Paul
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated Sep 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457355737 NPPES
Michigan MEDICAID 4406461

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