Provider Demographics
NPI:1093961658
Name:PEREIRA, DEREK JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:JOHN
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3629 WARNER DR APT 218
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-6051
Mailing Address - Country:US
Mailing Address - Phone:865-385-5944
Mailing Address - Fax:
Practice Address - Street 1:3629 WARNER DR APT 218
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-6051
Practice Address - Country:US
Practice Address - Phone:865-385-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program