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NPI Code Detail

MEDICARE: NOAH JOSIAH DERSCH PA

MEDICARE: NOAH JOSIAH DERSCH PA
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
1363A00000XPhysician AssistantGA

General Provider Information

NPI Number : 1447193511
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOAH JOSIAH DERSCH PA
Provider Business Mailing Address
First Line : 500 WASHINGTON ST SE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3628
Country : US
Telephone Number : 770-534-6100
Fax Number :
Provider Business Practice Location Address
First Line : 500 WASHINGTON ST SE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3628
Country : US
Telephone Number : 770-534-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ NOAH JOSIAH DERSCH PA” Practice Location

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