Individual
DERRICK WILLIAM CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12414 NAVES CROSSROAD NE, CUMBERLAND, MD 21502
(240) 808-8482
Mailing address
64 LAVALE CT, LAVALE, MD 21502-7421
(301) 697-6762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0008960
MD
Other
Enumeration date
04/16/2022
Last updated
08/16/2023
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