Individual
DR. EDWARD JUSTIN DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1016
(314) 362-7200
(314) 747-4189
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2018006395
MO
2085R0202X
Diagnostic Radiology Physician
Primary
35.137034
OH
Other
Enumeration date
04/23/2013
Last updated
08/24/2019
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