Individual
PAUL DERAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6695
(801) 374-9625
(801) 374-9690
Mailing address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6695
(801) 374-9625
(801) 374-9690
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
12054791-1205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
12054791-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/14/2011
Last updated
01/29/2025
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