Individual
DR. SCOTT JOHN DERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
21 PRIMROSE PL, BANGOR, ME 04401-5891
(207) 989-1054
Mailing address
21 PRIMROSE PL, BANGOR, ME 04401-5891
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
OS005372L
PA
207RC0000X
Cardiovascular Disease Physician
Primary
DO2065
ME
207RC0000X
Cardiovascular Disease Physician
OS005372L
PA
207RI0011X
Interventional Cardiology Physician
OS005372L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009784500006
—
PA
Enumeration date
03/02/2006
Last updated
11/09/2021
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