Individual
DR. BARRY P DERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
35055640
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0679207
—
OH
Enumeration date
08/23/2005
Last updated
05/08/2008
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