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Individual

DR. LUKE ALAN DEROO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2093 HEALTH DR SW STE 302, WYOMING, MI 49519-9691
(616) 252-5775
(616) 252-5785
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101019255
MI
207RG0100X
Gastroenterology Physician
Primary
5101019255
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D16078398
MI
Enumeration date
06/20/2011
Last updated
03/17/2018
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