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Individual

DERIC H NYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5601 W EUGIE AVE STE 100, GLENDALE, AZ 85304-1256
(602) 865-4510
(602) 865-6100
Mailing address
5601 W EUGIE AVE STE 100, GLENDALE, AZ 85304-1256
(602) 865-4510
(602) 865-6100

Taxonomy

Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
009320
AZ
207XP3100X
Pediatric Orthopaedic Surgery Physician
20A17398
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699014464
CA
Enumeration date
02/13/2013
Last updated
06/24/2025
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