OrganizationActive
Community Cancer Care Specialists
NPI 1407962442 · Non-Pharmacy Dispensing Site · Mount Clemens, MI
Provider details
- NPI number
- 1407962442
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Leslie Nowak, Practice Manager(586) 493-3435
- License
- 5101009575 (MI)
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1030 Harrington St
Ste 301
Mount Clemens, MI 48043-2967
Phone: (586) 493-3440
Fax: (586) 493-3455
Street-level locationGet directions
Mailing address
1030 Harrington St
Mount Clemens, MI 48043-2967
Other names (DBA / former)
- Doing business as
- Paul M Derderian DO
Registry dates
- Enumerated
- 2006-08-22
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.