Individual provider · Type 1 NPI

Michael Derevensky, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1740975689 Active

Practice location

2799 W Grand Blvd
Detroit, MI 48202-2689

Call (313) 916-2600 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1740975689

Michael Derevensky, MD's National Provider Identifier is 1740975689, issued on Apr 6, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Jul 2, 2026.