Individual
DERAY CHATTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
5332 E BASELINE RD APT 3040, MESA, AZ 85206-4739
(505) 947-9086
Mailing address
5332 E BASELINE RD APT 3040, MESA, AZ 85206-4739
(505) 947-9086
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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