Organization
M.M.DEREN,MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL M DEREN (PRESIDENT)
(860) 443-5469
Entity
Organization
Contact information
Practice address
125 SHAW ST, NEW LONDON, CT 06320-4900
(860) 443-5469
Mailing address
125 SHAW ST, NEW LONDON, CT 06320-4900
(860) 443-5469
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
15198
CT
Other
Enumeration date
04/12/2012
Last updated
04/24/2012
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