Organization
MEDIGYNE ASSOCIATES CH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WILLIAM DERUITER M.D. (PRESIDENT)
(850) 747-4963
Entity
Organization
Contact information
Practice address
2202 STATE AVE STE 311, PANAMA CITY, FL 32405-4590
(850) 747-4963
(850) 747-0074
Mailing address
2202 STATE AVE STE 311, PANAMA CITY, FL 32405-4590
(850) 747-4963
(850) 747-0074
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
ME0012877
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066314000
—
FL
Enumeration date
01/10/2008
Last updated
10/19/2010
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