Individual
JUSTIN MICHAEL DERSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 W NIFONG BLVD, BLDG 2, STE 220, COLUMBIA, MO 65203-5615
(573) 882-5673
(573) 884-4625
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2022026550
MO
Other
Enumeration date
04/22/2016
Last updated
02/20/2024
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