Individual
JOSEPH DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
205 MARION PIKE, COAL GROVE, OH 45638-3165
(740) 532-1188
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1329
WV
207V00000X
Obstetrics & Gynecology Physician
Primary
34004625
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000178447
ANTHEM BC
OH
01
—
001709561
MT.STATE
OH
01
—
001790560
MT. STATE
WV
05
—
0092290000
—
WV
05
—
0715417
—
OH
05
—
64698939
—
KY
Enumeration date
01/20/2006
Last updated
07/22/2024
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