Healthcare Provider Details

I. General information

NPI: 1881528339
Provider Name (Legal Business Name): HERMON MILIARD DERBEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

14600 BENTLEY PARK DR
BURTONSVILLE MD
20866-3126
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-5000
  • Fax:
Mailing address:
  • Phone: 240-505-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMTL600211613
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: