Individual
DAVID JOSEPH DERAIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
612 MAIN ST, CHAPMANVILLE, WV 25508
(304) 855-4529
(304) 855-5112
Mailing address
PO BOX 4357, CHAPMANVILLE, WV 25508-4357
(304) 855-4529
(304) 855-5112
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
861
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009267096
AETNA
—
01
—
001945851
BCBS
WV
01
—
1071821
BRICKSTREET WORKERS COMP
WV
05
—
3810008715
—
WV
01
—
633786
COVENTRY ADVANTRA FREEDOM
—
Enumeration date
02/12/2007
Last updated
05/21/2008
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