Individual
GEO SMITH DERIMANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 8 PENN TOWER, PHILADELPHIA, PA 19104
(215) 662-2415
Mailing address
3400 SPRUCE ST, DIVISION OF RHEUMATOLOGY, PHILADELPHIA, PA 19104-4206
(215) 662-2454
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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