Individual
DERYCK A KORHONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
N15995 MAIN ST, POWERS, MI 49874-9608
(906) 497-4360
(906) 497-4362
Mailing address
N15995 MAIN ST, POWERS, MI 49874-9608
(906) 497-4360
(906) 497-4362
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003474
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016972
RR MEDICARE GROUP#CC2139
MI
Enumeration date
08/05/2006
Last updated
07/24/2007
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