Dr DEREK R ILLASTRON is a male medical professional, specializing in Internal Medicine. He graduated in 2005.
MAUI MEDICAL GROUP INC
55 PUKALANI ST
MAKAWAO
HI
967688544
Tel: 8085736200
| Npi | 1790949956 |
| Pac Id | 8921176264 |
| Professional Enrollment Id | I20160504002708 |
| Last Name | ILLASTRON |
| First Name | DEREK |
| Middle Name | R |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2005 |
| Primary Specialty | INTERNAL MEDICINE |
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| Organization Legal Name | MAUI MEDICAL GROUP INC |
| Group Practice Pac Id | 7214823368 |
| Number Of Group Practice Members | 74 |
| Line 1 Street Address | 55 PUKALANI ST |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | MAKAWAO |
| State | HI |
| Zip Code | 967688544 |
| Phone Number | 8085736200 |
| Hospital Affiliation Ccn 1 | 120002 |
| Hospital Affiliation Lbn 1 | MAUI MEMORIAL MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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