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Individual

GEO SMITH DERIMANOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD068235L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00B962240001
PA
Enumeration date
06/24/2006
Last updated
11/13/2012
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