Organization
BARRY P. DERAN, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY P DERAN M.D. (OWNER)
(419) 897-7611
Entity
Organization
Contact information
Practice address
5705 MONCLOVA RD, SUITE 204, MAUMEE, OH 43537-1875
(419) 897-7611
(419) 897-7615
Mailing address
5705 MONCLOVA RD, SUITE 204, MAUMEE, OH 43537-1875
(419) 897-7611
(419) 897-7615
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2634224
—
OH
Enumeration date
12/06/2006
Last updated
05/08/2008
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