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Individual

DR. DEREK LEWIS TENNENHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1200 W CARMEL DR, #103, CARMEL, IN 46032-8707
(317) 796-3897
Mailing address
1200 W CARMEL DR, #103, CARMEL, IN 46032-8707
(317) 796-3897

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01056104C
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200374530
IN
Enumeration date
02/10/2009
Last updated
02/25/2017
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