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Individual

DR. DUANE E. DEIVERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
675 BALTIMORE DR, WILKES BARRE, PA 18702-7900
(570) 808-5757
(570) 808-5753
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-3034
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
OS012660
PA
208M00000X
Hospitalist Physician
OS012660
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101355085
PA
Enumeration date
02/27/2006
Last updated
08/10/2020
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