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Individual

DR. DONALD JOSEPH DERIVAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00014911
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000008502
MEDICARE INDIVIDUAL PROV
05
000008502
AL
01
051008502
BLUE CROSS BLUE SHIELD
AL
01
1497765721
NPI GROUP
01
180037758
RAILROAD MEDICARE
AL
01
H664
MEDICARE GROUP PROVIDER
AL
Enumeration date
12/21/2005
Last updated
05/08/2015
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