Deregis, David L

Deregis, David L is an individual health care provider with primary practice located at 1 Guthrie Sq Attention: Provider Services Vicky Detrick, Sayre PA 18840-1625. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is his primary health care specialty. Deregis, David L can be contacted via phone (570) 887-6323.

Contact Information

Primary practice address
1 Guthrie Sq Attention: Provider Services Vicky Detrick Sayre PA 18840-1625
Phone: (570) 887-6323
Fax: (570) 887-6324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35991 Kentucky
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 35991 Kentucky

Profile Details

NPI number 1770689895
LBN Legal business name Deregis, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Dec 13th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770689895 NPPES
Other 000000236623 BCBS PROVIDER NUMBER
Other 35991 BCBS PROVIDER NUMBER
MEDICAID 64018898 BCBS PROVIDER NUMBER

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