Individual
MR. DERELL LETWAUN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
481 COACHMAN DR APT G, SUMTER, SC 29154-6261
(803) 316-9253
Mailing address
481 COACHMAN DR APT G, SUMTER, SC 29154-6261
(803) 316-9253
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
226271
SC
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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