Derussy, Peter Kirk
Derussy, Peter Kirk is an sole proprietor health care provider with primary practice located at 2115 Leiter Rd , Miamisburg OH 45342-3659. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Derussy, Peter Kirk can be contacted via phone (937) 384-6800.Contact Information
Primary practice address
2115 Leiter Rd
Miamisburg OH 45342-3659
Phone: (937) 384-6800
Fax: (937) 384-6939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35 076115 | Ohio |
Profile Details
| NPI number | 1649251174 |
|---|---|
| LBN Legal business name | Derussy, Peter Kirk |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Feb 1st, 2021 - about 4 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 | 1649251174 | NPPES |
| Ohio | MEDICAID | 2507184 |
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