Individual
GAEL DEROUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2525 E ROOSEVELT ST, PHOENIX, AZ 85008-4948
(602) 344-1015
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
3052
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
581927
—
AZ
Enumeration date
05/20/2006
Last updated
09/19/2008
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