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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 1871618504 NPPES
Virginia Other 11718431 CAQH PROVIDER #

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