Deramus, Leonard Davey
Deramus, Leonard Davey is an individual health care provider with primary practice located at 55 Carlton St , Athens GA 30602-1503. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Deramus, Leonard Davey can be contacted via phone (706) 542-8609.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 001541 | Georgia |
Profile Details
| NPI number | 1073598645 |
|---|---|
| LBN Legal business name | Deramus, Leonard Davey |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2005 |
| Last updated | Jan 16th, 2013 - about 12 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 | 1073598645 | NPPES |
| Georgia | MEDICAID | 000261093B |
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