Derhake, Brian M
Derhake, Brian M is an individual health care provider with primary practice located at 200 Abraham Flexner Way , Louisville KY 40202-2877. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Derhake, Brian M can be contacted via phone (502) 587-4404.Contact Information
Primary practice address
200 Abraham Flexner Way
Louisville KY 40202-2877
Phone: (502) 587-4404
Fax: (502) 587-4156
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 44405 | Kentucky |
Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 44405 | Kentucky |
Profile Details
NPI number | 1508908781 |
---|---|
LBN Legal business name | Derhake, Brian M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 13th, 2007 |
Last updated | Jun 29th, 2022 - about 2 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 | 1508908781 | NPPES |
Indiana | MEDICAID | 201226160 | |
Indiana | Other | K017671 | |
Indiana | MEDICAID | 7100161850 |
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