Individual
DERICK S BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515B HERSHEY AVE, LANCASTER, PA 17603-5752
(717) 299-6372
(717) 945-1587
Mailing address
304 N WATER ST, LANCASTER, PA 17603-3374
(717) 735-6808
(717) 945-1587
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00041153
WA
207Q00000X
Family Medicine Physician
Primary
MD417531
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8317182
—
WA
Enumeration date
07/15/2006
Last updated
03/17/2018
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