Organization
COMMUNITY CANCER CARE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL M DERDERIAN D.O. (OWNER)
(586) 493-3440
Entity
Organization
Contact information
Practice address
1080 HARRINGTON ST, SUITE 202, MOUNT CLEMENS, MI 48043-2901
(586) 493-3440
(586) 493-3445
Mailing address
PO BOX 1169, MOUNT CLEMENS, MI 48046-1169
(586) 493-3440
(586) 493-3455
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
009575
MI
Other
Enumeration date
07/02/2006
Last updated
08/05/2009
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