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Individual

DR. DEREK C ARCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
36084401
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-084401#1
IL
Enumeration date
10/04/2006
Last updated
09/18/2008
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