Paul M Derderian Do

LBN: Community Cancer Care Specialists
Paul M Derderian Do is an health care organization with primary practice located at 1030 Harrington St Ste 301, Mount Clemens MI 48043-2967. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Non-Pharmacy Dispensing Site, Suppliers / Community/Retail Pharmacy. Suppliers / Non-Pharmacy Dispensing Site is the primary health care specialty. Community Cancer Care Specialists can be contacted via phone (586) 493-3440, or through Nowak, Leslie via phone (586) 493-3435.

Contact Information

Primary practice address
1030 Harrington St Ste 301 Mount Clemens MI 48043-2967
Phone: (586) 493-3440
Fax: (586) 493-3455
Website:
Map and Directions
Authorized official contact:
Name: Nowak, Leslie
Phone: (586) 493-3435

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5101009575 Michigan

Profile Details

NPI number 1407962442
LBN Legal business name Community Cancer Care Specialists
DBA Doing business as Paul M Derderian Do
Authorized official Nowak, Leslie
Entity Organization
Organization subpart 1 No
Enumeration date Aug 22nd, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407962442 NPPES
Other 2368430 OTHER ID NUMBER-COMMERCIAL NUMBER

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