Organization
MICHIGAN VASCULAR INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY P. DERDERIAN D.O. (MEMBER)
(248) 594-3091
Entity
Organization
Contact information
Practice address
538 N OLD WOODWARD AVE, BIRMINGHAM, MI 48009-5375
(248) 594-3091
(248) 594-3068
Mailing address
538 N OLD WOODWARD AVE, BIRMINGHAM, MI 48009-5375
(248) 594-3091
(248) 594-3068
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
5101007182
MI
Other
Enumeration date
07/19/2007
Last updated
02/23/2023
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