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General NPI Number Information
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NPI Number | 1528199379
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Entity Type | Organization
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Legal Business Name | T CRAIG DERIAN MD PLLC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 4206 N ROXBORO STREET SUITE 120
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City | DURHAM
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State | NC
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Zip | 27704-1868
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Country | US
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Telephone | 919-479-4160
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Fax | 919-479-4116
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Provider Business Mailing Address
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Address Line | 4206 N ROXBORO STREET SUITE 120
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City | DURHAM
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State | NC
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Zip | 27704-1868
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Country | US
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Telephone | 919-479-4160
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Fax | 919-479-4116
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS CRAIG DERIAN
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Credential | MD
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Telephone | 919-479-4160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 31269
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License Number State | NC
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