Individual
DR. COLIN P DERDEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-1009
(434) 924-9400
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101280416
VA
2085N0700X
Neuroradiology Physician
105361
MO
2085N0700X
Neuroradiology Physician
MD43047
IA
2085R0202X
Diagnostic Radiology Physician
Primary
0101280416
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268010377
—
MO
Enumeration date
07/14/2006
Last updated
01/05/2024
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