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General NPI Number Information
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NPI Number | 1053310078
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Entity Type | Individual
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Provider Name | JAMES B. DEREN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1050 W INDUSTRIAL BLVD
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City | CUMBERLAND
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State | MD
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Zip | 21502-4331
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Country | US
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Telephone | 240-964-9355
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Fax | 240-964-9356
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Provider Business Mailing Address
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Address Line | PO BOX 1671
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City | CUMBERLAND
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State | MD
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Zip | 21501-1671
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Country | US
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Telephone | 240-964-8342
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Fax | 240-964-8337
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0042053
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25568
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0042053
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License Number State | MD
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