Organization
COMMUNITY CANCER CARE SPECIALISTS
Active
Other names
PAUL M DERDERIAN DO
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE NOWAK (PRACTICE MANAGER)
(586) 493-3435
Entity
Organization
Contact information
Practice address
1030 HARRINGTON ST, STE 301, MOUNT CLEMENS, MI 48043-2967
(586) 493-3440
(586) 493-3455
Mailing address
1030 HARRINGTON ST, STE 301, MOUNT CLEMENS, MI 48043-2967
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
3336C0003X
Community/Retail Pharmacy
5101009575
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368430
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/22/2006
Last updated
09/11/2025
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