Individual
BRUCE JAMES DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 ERWIN RD, DURHAM, NC 27705-3941
(919) 684-8111
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2012-00981
NC
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
2012-00981
NC
Other
Enumeration date
06/16/2009
Last updated
11/29/2012
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