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
Phone: (719) 553-2205
Fax: (833) 314-0183
Website:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093777658 | NPPES |
| Colorado | MEDICAID | 59626569 |
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