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Individual

DR. ADAM DERHAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
125046367
IL
207X00000X
Orthopaedic Surgery Physician
ME101080
FL

Other

Enumeration date
02/18/2008
Last updated
02/08/2010
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