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Individual

DR. SCOTT ALAN DERUITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
109 S BURLINGTON DR, PUEBLO, CO 81007-5560
(719) 553-2205
(833) 314-0183
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-2200
(719) 553-2216

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43016
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
59626569
CO
Enumeration date
04/06/2006
Last updated
03/28/2024
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