Individual
DR. DAVID PETER DEROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001317
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27705
GEISINGER HEALTH PLAN #
PA
01
—
OEG001317
PA LICENSE NUMBER
PA
Enumeration date
08/30/2006
Last updated
03/07/2023
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