Donovan, Derek Michael

Donovan, Derek Michael is an individual health care provider with primary practice located at 300 W Ottley Ave , Fruita CO 81521-2118. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Donovan, Derek Michael can be contacted via phone (970) 858-2119.

Contact Information

Primary practice address
300 W Ottley Ave Fruita CO 81521-2118
Phone: (970) 858-2119
Fax: (970) 858-2743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X DR.0067052 Colorado
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 18856 New Hampshire

Profile Details

NPI number 1902293376
LBN Legal business name Donovan, Derek Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2015
Last updated Sep 1st, 2021 - about 5 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 1902293376 NPPES
Vermont MEDICAID 1033088
Vermont MEDICAID 3112479

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