Most Relevant Information
Provider Data
| NPI Number: | 1003536541 |
| Provider Name: | DEREK CURTIS THAMARUS |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 4704226619 |
Most Important Dates
| Enumeration Date: | 09/02/2022 |
| Last Updated: | 09/02/2022 |
Provider Practice Location
4646 JOHN R ST
DETROIT
MI
482011916
Practice Location Phone/Fax
| Phone: | 3135761294 |
| Fax: |
Provider Mailing Location
4646 JOHN R ST
DETROIT
MI
482011916
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |