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Individual

DERRICK J SANDERSON

Active
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Individual

DERRICK J SANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
283330
NY
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
02005887A
IN
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
81662
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300038901
IN
05
7100666260
KY
Enumeration date
04/23/2012
Last updated
11/08/2024
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