Deruiter, Scott Alan

Deruiter, Scott Alan is an individual health care provider with primary practice located at 109 S Burlington Dr , Pueblo CO 81007-5560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deruiter, Scott Alan can be contacted via phone (719) 553-2205.

Contact Information

Primary practice address
109 S Burlington Dr Pueblo CO 81007-5560
Fax: (833) 314-0183
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 43016 Colorado

Profile Details

NPI number 1093777658
LBN Legal business name Deruiter, Scott Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Mar 28th, 2024 - about 9 months 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 1093777658 NPPES
Colorado MEDICAID 59626569

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