Individual
DERRICK WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20755 GREENFIELD RD STE 100, SOUTHFIELD, MI 48075-5400
(947) 282-5009
(248) 809-2319
Mailing address
20755 GREENFIELD RD STE 100, SOUTHFIELD, MI 48075-5400
(947) 282-5009
(248) 809-2319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009333
MI
208D00000X
General Practice Physician
DW009333
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215922059
—
MI
05
—
437095911
—
MI
Enumeration date
09/19/2005
Last updated
11/02/2022
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