TARA DERYAVOUSH

MOUNT CLEMENS, MI
NPI1851718092
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MI  5101020870)
Additional Taxonomies208M00000X Hospitalist
(Licence: MI  5101020870)
Enumeration Date2014-03-26
Last Update Date2022-07-21
Business Address
TARA DERYAVOUSH D.O
133 S MAIN ST
MOUNT CLEMENS, MI 48043-2308
Phone number: 586-468-1600
Mailing Address
TARA DERYAVOUSH D.O
50505 SCHOENHERR RD STE 340
SHELBY TOWNSHIP, MI 48315-3140
Phone number: 586-731-8400