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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457355737 | NPPES |
| Michigan | MEDICAID | 4406461 |
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