Healthcare Provider Details

I. General information

NPI: 1831775717
Provider Name (Legal Business Name): DEREK DRAPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 07/12/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10099 RIDGEGATE PKWY STE 200
LONE TREE CO
80124-5532
US

IV. Provider business mailing address

10101 RIDGEGATE PKWY
LONE TREE CO
80124-5522
US

V. Phone/Fax

Practice location:
  • Phone: 720-875-2880
  • Fax: 720-875-2877
Mailing address:
  • Phone: 720-225-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTL0008724
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: