Individual
DERRICK EDWARD TOBIAS
Active
Individual
DERRICK EDWARD TOBIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39298
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000515641
ANTHEM - NINPTSPEC
—
01
—
000028412O
HUMANA - NIS
KY
01
—
0752823
CIGNA - NIS
KY
01
—
085911
SIHO - NIS
KY
05
—
200803120
—
IN
01
—
2648495000
PAD - NINPTSPEC
—
01
—
50014705
PASSPORT - NINPTSPEC
—
05
—
64105570
—
KY
01
—
P00460518
RR-MCR-KY - NIS
KY
Enumeration date
02/09/2006
Last updated
07/21/2016
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