Individual
DEREK POLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
19850 M GIBRALTAR RD, GIBRALTAR, MI 48173-8701
(734) 301-3125
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
021315
OH
363L00000X
Nurse Practitioner
4704292642
MI
363LF0000X
Family Nurse Practitioner
Primary
4704292642
MI
Other
Enumeration date
09/12/2017
Last updated
12/22/2024
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