Derdeyn, Amalie S
Derdeyn, Amalie S is an individual health care provider with primary practice located at 3350 Berkmar Drive , Charlottesville VA 22901. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Derdeyn, Amalie S can be contacted via phone (434) 923-4651.Contact Information
Primary practice address
3350 Berkmar Drive
Charlottesville VA 22901
Phone: (434) 923-4651
Fax: (434) 964-3636
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 0101241359 | Virginia |
Profile Details
| NPI number | 1871618504 |
|---|---|
| LBN Legal business name | Derdeyn, Amalie S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Apr 14th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871618504 | NPPES |
| Virginia | Other | 11718431 | CAQH PROVIDER # |
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