Individual
DR. MELANIO M DERRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 CHAMBERS RD, CARO, MI 48723-9293
(989) 673-3191
(989) 673-0064
Mailing address
2000 CHAMBERS RD, CARO, MI 48723-9293
(989) 673-3191
(989) 673-0064
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
17095
WV
207Q00000X
Family Medicine Physician
Primary
4301401337
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G96037
MEDICARE PART B
MI
05
—
1758845
—
MI
01
—
234025
MEDICARE PART A
MI
Enumeration date
09/22/2006
Last updated
09/25/2009
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