Provider Demographics
NPI:1730542275
Name:KORZYM, DEREK MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:MATTHEW
Last Name:KORZYM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17077 DUNSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-2357
Mailing Address - Country:US
Mailing Address - Phone:248-325-7788
Mailing Address - Fax:
Practice Address - Street 1:37595 7 MILE RD STE 210
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1003
Practice Address - Country:US
Practice Address - Phone:734-853-5660
Practice Address - Fax:734-853-5697
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301117175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine