Individual
DR. JEFFREY A. DERUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, STE 370, MILWAUKEE, WI 53215-3669
(414) 649-1280
Mailing address
2801 W KINNICKINNIC RIVER PKWY, STE 370, MILWAUKEE, WI 53215-3669
(414) 649-1280
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
27601
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31584200
—
WI
Enumeration date
10/31/2005
Last updated
11/30/2021
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