Individual
DEREK VANDERVELDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 PEPPERELL PKWY, OPELIKA, AL 36801-5452
(334) 528-1112
Mailing address
2000 PEPPERELL PKWY, OPELIKA, AL 36801-5452
(334) 528-1112
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2022-00403
NC
207P00000X
Emergency Medicine Physician
Primary
DO.3215
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
10/15/2024
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