Individual
DEREK JOHN WILLIAM PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10630 CLEMSON BLVD, SUITE 100, SENECA, SC 29678-4546
(864) 482-6000
(864) 482-7000
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1057877 NCCPA
—
363A00000X
Physician Assistant
Primary
1839
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1544PA
—
SC
Enumeration date
01/08/2007
Last updated
06/30/2021
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