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Individual
DERIK THOMPSON
Active
Individual
DERIK THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0136000166
VA
Other
Enumeration date
07/09/2009
Last updated
12/19/2019
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