Individual
CARA E DERCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1725 WESTERN AVE STE A, FINDLAY, OH 45840-1390
(419) 423-4994
(419) 423-4110
Mailing address
1725 WESTERN AVE STE A, FINDLAY, OH 45840-1390
(419) 423-4994
(419) 423-4110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.014037
OH
207Q00000X
Family Medicine Physician
5101018178
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
34.014037
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
5101018178
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362679
—
OH
01
—
H651420
MEDICARE-OH
OH
Enumeration date
09/23/2009
Last updated
10/07/2019
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