Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEROME D. DERDEL, MD
ActiveJEROME D. DERDEL, MD is a 2085R0203X healthcare provider located in STATE COLLEGE, Pennsylvania. NPI 1104812601 is currently active in the NPPES registry. Verify at CMS.
2085R0203X · STATE COLLEGE, PA
Registration Details
- NPI Number
- 1104812601
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2005 (20.93706130746 yrs)
- Last Updated
- Jun 21, 2023
- Licenses
-
MD038685L (PA)MD038685L (PA)
Practice Information
- Address
-
1800 E PARK AVESTATE COLLEGE, PA, 168036709Browse PA providers · Browse ZIP 16803
- Phone
- 8142346726
- Fax
- 8142341553
- Primary Specialty
-
2085R0203X
2085R0203X
- Additional Specialty
- 2085R0203X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.