Derek Paul Pendarvis in Gainesville - Surgery
Derek Paul Pendarvis - NPI 1104806108
Derek Paul Pendarvis is a Surgery in Gainesville, Georgia. Derek Paul Pendarvis practices all healthcare services and medical treatments related to Surgery. The NPI Number for Derek Paul Pendarvis is 1104806108. The last update date is 2019-03-07.
Derek Paul Pendarvis's current location address is Po Box 658, Gainesville, Georgia. You can contact this provider via phone number 7707181122 and fax number 7705357445. The mailing address for Derek Paul Pendarvis is Po Box 658, Gainesville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derek Paul Pendarvis |
|---|---|
| Address | Po Box 658, Gainesville, Georgia |
| Phone Number | 7707181122 |
| Fax Number | 7705357445 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1104806108 |
|---|---|
| Provider Enumeration Date | 2006-01-18 |
| Last Updated Date | 2019-03-07 |
Provider Mailing Address Detail
| Address | Po Box 658 |
|---|---|
| City | Gainesville |
| State | Georgia (GA) |
| Post Code | 305030658 |
| Phone Number | 7707181122 |
| Fax Number | 7705357445 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 49933 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 52843776 | GA | BCBS | |
| 000904274A | GA | -- | |
| 341106 | GA | WELLCARE | |
| 1700231 | GA | UNITED HEALTHCARE | |
| 000904274B | GA | -- | |
| 20050660 | GA | RR MEDICARE-GRP # CC4177 | |
| 10045029 | GA | AMERIGROUP | |
| 7816063 | GA | CIGNA |
Post Comment/ Review Below
What is the unique provider identifier assigned to Derek Paul Pendarvis?
The Derek Paul Pendarvis has been issued the NPI (National Provider Identifier) 1104806108 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Derek Paul Pendarvis is geographically located?
The Derek Paul Pendarvis is physically situated at the following location: Po Box 658, Gainesville, GA, 305030658.
What is the area of specialization for Derek Paul Pendarvis, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Derek Paul Pendarvis is Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 208600000X.
When did Derek Paul Pendarvis receive its 1104806108 assignment?
The Derek Paul Pendarvis was assigned its 1104806108 on 2006-01-18, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to Derek Paul Pendarvis, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Derek Paul Pendarvis, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2019-03-07.