Provider Demographics
NPI:1699663864
Name:THOMAS, DEREK TREMAYNE
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:TREMAYNE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15560 JOY RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-8200
Mailing Address - Country:US
Mailing Address - Phone:313-668-9300
Mailing Address - Fax:
Practice Address - Street 1:15560 JOY RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-8200
Practice Address - Country:US
Practice Address - Phone:313-668-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist