Organization
HAGOP L DERKRIKORIAN, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAGOP LEVON DERKRIKORIAN M.D. (PRESIDENT)
(610) 566-7787
Entity
Organization
Contact information
Practice address
1098 W BALTIMORE PIKE, SUITE 3306, MEDIA, PA 19063-5139
(610) 566-7787
(610) 892-9127
Mailing address
1098 W BALTIMORE PIKE, SUITE 3306, MEDIA, PA 19063-5139
(610) 566-7787
(610) 892-9127
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030876000
IBC
PA
01
—
2146620000
IBC
DE
Enumeration date
09/24/2007
Last updated
02/26/2008
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