Individual
DONALD A. DEROLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
321 VAUCLUSE AVE, MIDDLETOWN, RI 02842-5786
(401) 683-8895
(401) 849-5780
Mailing address
321 VAUCLUSE AVE, MIDDLETOWN, RI 02842-5786
(401) 683-8895
(401) 849-5780
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD 05292
RI
207Q00000X
Family Medicine Physician
Primary
MD05292
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003642
RI BLUE CHIP
RI
01
—
20375-3
RI BC/BS
RI
05
—
7003354
—
RI
Enumeration date
07/01/2005
Last updated
02/25/2020
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