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:
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Health care specialties

SpecialtyCodeLicense #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 3 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 1508908781 NPPES
Indiana MEDICAID 201226160
Indiana Other K017671
Indiana MEDICAID 7100161850

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