MEDICARE: DR. WILLIAM DEREK SHOWS PH.D.

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	103T00000X	Psychologist	198	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0310T	OTHER	NC	BCBS PROVIDER NKUMBER

General Provider Information

NPI Number	:	1386621308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM DEREK SHOWS PH.D.

Provider Business Mailing Address
First Line	:	12 UPCHURCH CIR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-5629
Country	:	US
Telephone Number	:	919-490-0883
Fax Number	:	919-403-3437

Provider Business Practice Location Address
First Line	:	12 UPCHURCH CIR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-5629
Country	:	US
Telephone Number	:	919-490-0883
Fax Number	:	919-403-3437

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	12/14/2025

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