Individual
DR. TODD MICHAEL DERREBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2554 LEWISVILLE CLEMMONS RD STE 207, CLEMMONS, NC 27012-9752
(336) 223-8220
(339) 207-0143
Mailing address
2554 LEWISVILLE CLEMMONS RD STE 207, CLEMMONS, NC 27012-9752
(336) 223-8220
(339) 207-0143
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2015-00894
NC
2084P0800X
Psychiatry Physician
25736
WV
2084P0805X
Geriatric Psychiatry Physician
25736
WV
Other
Enumeration date
06/18/2009
Last updated
06/10/2020
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