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Individual

DEREK BURYL HEMERICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2050A 2ND ST NE, KIRTLAND AFB, NM 87108
(505) 843-3200
Mailing address
2050A 2ND ST SE, KIRTLAND, NM 87108
(505) 846-3200

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
10/12/2021
Last updated
03/27/2023
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