Individual
DEREK MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346
(910) 721-1000
Mailing address
4 OAK RIDGE DR, MORGANTOWN, WV 26508-8620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7355
NC
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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