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Individual
ISAAC DEATHERAGE
Active
Individual
ISAAC DEATHERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO, MPH
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101028511
MI
Other
Enumeration date
04/27/2023
Last updated
04/09/2025
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