Marvin J. Derrick M.D.

NPI 1497855886 - Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X

NPI Details
NPI 1497855886
Gender Male
Enumeration Date 09/25/2006
Last Updated 11/24/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
2300 N EDWARD ST
SUITE 2350
DECATUR IL, 62526-4163, US
Phone (217) 876-2880
Fax (217) 876-2885
Business Location
2300 N EDWARD ST
GSBLL
DECATUR IL, 62526-4163, US
Phone (217) 876-2857
Fax (217) 876-2874
Toxanomy
Taxonomy Code 208G00000X
License State California
License Number G47855
Remove 1497855886 NPI Number
 

According to our database, Dr. Marvin J. Derrick M.D. NPI is 1497855886, taxonomy code is 208G00000X and license number is G47855, license state is located at California. Marvin J. Derrick M.D. physically located at 2300 N Edward St, Decatur IL, 62526-4163. NPI Number Marvin J. Derrick M.D. has the Individual type.

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1497855886 NPI number is provided on an as is basis without warranty of any kind. 1497855886 is maintained by the National Plan & Provider Enumeration System. The contents of Marvin J. Derrick M.D. are for informational purposes only.