Individual
DEREK MICHAEL DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-2119
(970) 858-2743
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 858-2186
(970) 858-2208
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
18856
NH
207P00000X
Emergency Medicine Physician
Primary
DR.0067052
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033088
—
VT
05
—
3112479
—
NH
Enumeration date
04/23/2015
Last updated
09/01/2021
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