Individual
DR. DERRICK C PAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
076620
GA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
076620
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312691B
—
GA
01
—
202I189735
MEDICARE PTAN
GA
Enumeration date
11/05/2008
Last updated
03/05/2019
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