Individual
DEREK PIVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003-6379
(304) 243-3000
Mailing address
1 MEDICAL PARK, WHEELING, WV 26003-8567
(304) 243-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1996
WV
Other
Enumeration date
07/31/2012
Last updated
09/19/2022
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