MEDICARE: DERRICK COLMENAR M.D., FASA, FACHE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	0101255889	VA
2	207L00000X	Anesthesiology Physician	A96706	CA

General Provider Information

NPI Number	:	1326145970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERRICK COLMENAR M.D., FASA, FACHE

Provider Business Mailing Address
First Line	:	PSC 808 BOX 19
Second Line	:
City	:	FPO
State	:	AE
Zip	:	09618-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	U.S. NAVAL HOSPITAL
Second Line	:	VIA CONTRADA BOSCARIELLO
City	:	GRICIGNANO DI AVERSA
State	:	CE
Zip	:	81030
Country	:	IT
Telephone Number	:	81-811-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	07/16/2024

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