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NPI Code Detail

MEDICARE: DERRELL HESTER

MEDICARE: DERRELL HESTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1083944292
Entity Type Code : Individual
Provider Name (Legal Business Name) : DERRELL HESTER
Provider Business Mailing Address
First Line : 9237 PIEDMONT ST
Second Line :
City : DETROIT
State : MI
Zip : 48228-1726
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19401 NORTHLINE RD
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-2277
Country : US
Telephone Number : 734-785-7718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2010
Last Update Date : 01/11/2010

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Directions to “ DERRELL HESTER ” Practice Location

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