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Individual

DR. CHAD A DEROSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1650 COCHRANE CIR, UROLOGY SERVICE, EVANS ARMY COMMUNITY HOSPITAL, FORT CARSON, CO 80913-4613
(719) 526-7115
Mailing address
1650 COCHRANE CIR, UROLOGY SERVICE, FORT CARSON, CO 80913-4613
(719) 526-7115

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
01061241A
IN
208800000X
Urology Physician
Primary
DR.0052374
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
028857
KAISER COMMERCIAL NUMBER
CO
05
55980767
CO
Enumeration date
08/08/2007
Last updated
06/21/2021
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