DEREK BAST

INDIANAPOLIS, IN
NPI1437612272
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  02006451A)
Enumeration Date2019-04-09
Last Update Date2023-02-23
Business Address
DEREK BAST DO
426 S ALABAMA ST STE 100
INDIANAPOLIS, IN 46225-3301
Phone number: 317-528-2489
Mailing Address
DEREK BAST DO
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800
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