Individual
OUASSIM DERBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 SMITH CHURCH RD, ROANOKE RAPIDS, NC 27870-4914
(252) 535-8011
Mailing address
17303 MUSSELBURGH DR, CARY, NC 27518-6976
(305) 318-8522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2021-01829
NC
390200000X
Student in an Organized Health Care Education/Training Program
239615
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/03/2018
Last updated
08/03/2021
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