KRISTIN M DERDERIAN (NPI# 1376624130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376624130 |
| Entity Type | Individual |
| Full Name | KRISTIN M DERDERIAN |
| Credential | DO |
| Practice Address |
28080 Grand River Ave Ste 306 Farmington Hills MI 48336-5966 |
| Mailing Address |
26901 Beaumont Blvd Ste 3d Southfield MI 48033-3849 |
| Practice Telephone | 9475218314 |
| Practice Fax Number | 2484788864 |
| Mailing Telephone | 9475221862 |
| Mailing Fax Number | 9475220307 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
5101013350 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14510 Northline Rd, Southgate, MI 481952402 | 7342822800 | 7342822828 |
| Street Address |
28080 GRAND RIVER AVE STE 306 |
| City | FARMINGTON HILLS |
| State | MI |
| Zip Code | 48336-5966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366824807 | Michelle Lee | Internal Medicine | 28080 Grand River Ave Ste 306, Farmington Hills, MI 48336 | 2015-06-21 |
| 1366707531 | Dresden Hans Paul Beier | Podiatrist | 28080 Grand River Ave Ste 306, Farmington Hills, MI 48336-5966 | 2012-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733375 | Compassionate Attendant Care Inc | Home Health | 21100 Osmus Street, Suite E, Farmington Hills, MI 48336 | 2020-02-25 |
| 1578123790 | Jon Boynton | Audiologist-Hearing Aid Fitter | 25882 Orchard Lake Rd, Suite 103, Farmington Hills, MI 48336 | 2019-06-19 |
| 1083270078 | Bethesda Home Health LLC | Home Health | 34445 Northwestern Hwy, Farmington Hills, MI 48336 | 2019-05-15 |
| 1174005227 | Cisseri Health Care | Home Health | 28931 W 11 Mile Rd, Farmington Hills, MI 48336 | 2018-09-05 |
| 1326531294 | April A Jackson | Psychologist | 24211 Farmington Road, Farmington Hills, MI 48336 | 2018-06-14 |
| 1083136642 | Nicole Renee Cannonier | Social Worker | 25311 Lynford, Farmington Hills, MI 48336 | 2017-07-14 |
| 1174052021 | Sharon Suzanne King | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21600 Tulane, Farmington Hills, MI 48336 | 2017-06-05 |
| 1639578909 | Alyssa Kaitlyn Brecht | Rehabilitation Counselor | 23062 Middlebelt Rd, Apt 103, Farmington Hills, MI 48336 | 2014-08-22 |
| 1184038341 | Therapeutic Advantage LLC | Occupational Therapist | 30903 W 10 Mile Rd Ste B, Farmington Hills, MI 48336 | 2014-06-16 |
| 1952727257 | Takara Orum | Social Worker | 21399 Tulane Ave, Apt. 301, Farmington Hills, MI 48336 | 2014-03-11 |
| Find all providers in zip 48336 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629095534 | Infectious Disease Center, P.C. | Internal Medicine | 24350 Orchard Lake Rd, Ste. 115, Farmington Hills, MI 48336-1970 | 2006-07-16 |
| 1457396285 | Robert Gregory Smith | Internal Medicine | 28080 Grand River Ave, Suite 306, Farmington Hills, MI 48336-5966 | 2006-06-17 |
| 1053356899 | Susan J Knoll-vlachos | Internal Medicine | 28080 Grand River Ave, Suite 306, Farmington Hills, MI 48336-5966 | 2006-06-17 |
| 1477597326 | Gerald W Blackburn | Internal Medicine | 28080 Grand River Ave, Suite 306, Farmington Hills, MI 48336-5966 | 2006-06-15 |
| 1811939572 | Wiley Fan | Internal Medicine | 28080 Grand River Ave, Suite 306, Farmington Hills, MI 48336-5966 | 2006-06-10 |
| 1467494138 | Botsford General Hospital | Internal Medicine | 28080 Grand River Ave, Suite 306, Farmington Hills, MI 48336-5966 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255830121 | Infectious Disease Experts, Pllc | Internal Medicine | 5757 Springbrook Dr, Troy, MI 48098-5308 | 2018-02-06 |
| 1497205546 | Capitol Infectious Disease Associates | Internal Medicine | 6401 Pine Hollow Dr, East Lansing, MI 48823-9737 | 2016-10-12 |
| 1932517604 | Nkechi Mbanefo Azie | Internal Medicine | 1660 Pond Shore Dr, Ann Arbor, MI 48108-9565 | 2014-07-25 |
| 1780096032 | Quentin Doperalski | Internal Medicine | 560 W Mitchell St Ste 170, Petoskey, MI 49770-2276 | 2014-05-21 |
| 1215361373 | Kimberly A Zielke | Internal Medicine | 720 West Wackerly, Suite 111, Midland, MI 48640 | 2013-08-26 |
| 1235572462 | Erika Olson | Internal Medicine | Harper University Hospital, 3990 John R Street, 5 Hudson, Detroit, MI 48201 | 2013-04-08 |
| 1750648945 | Daniela Christina Pellegrini | Internal Medicine | 1700 Clinton St # At, Muskegon, MI 49442-5502 | 2012-04-12 |
| 1033442546 | Guided Care Community Services Corp. | Internal Medicine | 535 Griswold St, Suite 111-267, Detroit, MI 48226-3604 | 2009-09-15 |
| 1023246329 | Ashish Bhargava | Internal Medicine | 19251 Mack Ave Ste 333, Grosse Pointe Woods, MI 48236-2898 | 2009-06-24 |
| 1104099266 | Aneela Yaqoob | Internal Medicine | 3515 Parklawn Dr, Canton, MI 48188-2315 | 2008-04-09 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON HILLS |
| Zip Code | 48336 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.