Individual
DR. LISA MARIE DERANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15400 PEARL RD STE 238, STRONGSVILLE, OH 44136-6000
(440) 879-1108
Mailing address
1512 BEACON HILL DR, WADSWORTH, OH 44281-8124
(330) 715-4808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35060402
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0528125
—
OH
05
—
0928125
—
OH
Enumeration date
08/02/2006
Last updated
03/13/2023
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